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KMID : 1034720190110020158
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Journal of Neurosonology and Neuroimaging
2019 Volume.11 No. 2 p.158 ~ p.161
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Cryptogenic Stroke Caused by a Carotid Web with a Superimposed Thrombosis: Serial Neurosonologic Findings
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Kwon Jung-A
Gwak Dong-Seok
Shim Dong-Hyun
Kim Yong-Won
Hwang Yang-Ha
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Abstract
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Recently, carotid web has been considered as an infrequent cause of cryptogenic stroke in young patients with no other identifiable stroke etiologies. It could lead to thrombus formation in the rostral aspects of the web, which subsequently provokes artery-to-artery embolism to the anterior circulation. A 48-year-old man who underwent endovascular mechanical thrombectomy for acute right middle cerebral artery occlusion was found to have a carotid web as the etiology of the index stroke. Owing to the presence of parenchymal hematoma after the thrombectomy, the administration of antithrombotics was withheld. Serial monitoring with carotid ultrasonography (CUS) revealed a reemergence of the superimposed thrombosis along the web, which necessitated urgent anticoagulation to prevent recurrent brain embolism. Therefore, serial monitoring with CUS could reveal valuable information regarding any presence of superimposed thrombosis on the web, which may revamp the preventive strategies in patients with acute stroke and carotid web
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KEYWORD
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Cerebral infarction, Carotid artery thrombosis, Ultrasonography, Fibromuscular dysplasia
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