Carotid Web as a Source of Thromboembolism in a Young African American Female

Eric Assid; Chad Hall; Mawadah Samad; Richard Zweifler

doi:10.31486/toj.23.0082

Carotid Web as a Source of Thromboembolism in a Young African American Female

Ochsner J. 2024 Spring;24(1):87-89. doi: 10.31486/toj.23.0082.

Authors

Eric Assid¹, Chad Hall², Mawadah Samad³, Richard Zweifler^{3

4}

Affiliations

¹ Department of Sports Medicine, Ochsner Clinic Foundation, New Orleans, LA.
² School of Medicine, Tulane University, New Orleans, LA.
³ The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA.
⁴ Department of Neurology, Ochsner Clinic Foundation, New Orleans, LA.

Abstract

Background: Carotid webs are nonatherosclerotic fibrous bands that may alter hemodynamic flow and increase the risk of platelet aggregation, leading to thromboembolism in young, otherwise healthy individuals. Although rare, carotid webs are important causes of thromboembolic strokes and are often overlooked in the routine workup for a stroke. Treating physicians and radiologists must recognize and properly manage patients who present with carotid webs to prevent recurrent thromboembolism. Case Report: A healthy 30-year-old female presented with slurred speech and unilateral left upper and lower extremity numbness. Imaging modalities showed an acute infarction of the right middle cerebral artery and bilateral carotid webs. The patient was managed operatively with a right carotid endarterectomy and discharged on day 3 of admission on a regimen of ticagrelor, amlodipine, and aspirin. The patient was asymptomatic at 1-year follow-up. Conclusion: Our case highlights the clinical relevance of considering carotid web as a potential etiology for ischemic stroke in young, otherwise healthy patients and emphasizes the importance of timely diagnosis and appropriate management to prevent recurrent cerebrovascular events.

Keywords: Carotid artery diseases; carotid sinus; stroke; thromboembolism.

Publication types

Case Reports