Carotid web – a rare cause of ischemic stroke

Abstract

Introduction: A carotid web is a rare but clinically important cause of cryptogenic ischemic stroke. It is an atypical form of fibromuscular dysplasia localized at the carotid bulb. The aim of this paper is to present this less-known cause of ischemic stroke based on a case study.

Case report: In a 55-year-old female patient with acute ischemic strok in the left carotid territory, a carotid web was diagnosed on CT angiography. Other extracranial or intracranial cerebral arteries showed no stenoses or occlusions. The patient was initially treated effectively with intravenous thrombolysis. A follow-up brain MRI revealed a small cortical ischemia and a detailed cardiological evaluation excluded the cardioembolic etiology of the stroke. As part of the secondary stroke prevention, the patient was managed with antiplatelet therapy and underwent an uncomplicated carotid endarterectomy. During a 10-month follow-up period, there was no recurrence of cerebral ischemia.

Conclusion: Carotid endarterectomy represents a safe and effective method for treating symptomatic carotid web.

doi: 10.48095/ccrvch2025262