Oscillating thromboemboli within the extracranial internal carotid artery demonstrated by ultrasonography in patients with acute cardioembolic stroke

Ultrasound Med Biol. 1998 Oct;24(8):1121-4. doi: 10.1016/s0301-5629(98)00108-2.


We detected oscillating thromboemboli at the extracranial internal carotid artery (ICA) by duplex carotid ultrasonography in patients with acute cardioembolic stroke. Using B-mode ultrasonography, we evaluated the extracranial ICA in 11 patients with acute cardioembolic ICA occlusion. A homogeneous, elastic, oscillating intraluminal mass echo originating in the extracranial ICA extended distally in 5 (46%) of these patients. The echoes moved quickly and distally during the systolic phase of the cardiac cycle and returned slowly to the original position during the diastolic phase. We performed a postmortem study 24 days after stroke onset in 1 patient with an oscillating intraluminal mass echo that had been demonstrated by duplex ultrasonography. The ICA lumen was obstructed with a fresh string-like thrombus. The findings of oscillating intraluminal mass echo may help establish a diagnosis of acute embolic ICA occlusion.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Blood Flow Velocity
  • Carotid Artery Thrombosis / diagnostic imaging*
  • Carotid Artery Thrombosis / etiology
  • Carotid Artery, Internal / diagnostic imaging*
  • Cerebral Angiography
  • Cerebrovascular Disorders / diagnostic imaging*
  • Cerebrovascular Disorders / etiology
  • Female
  • Follow-Up Studies
  • Heart Diseases / complications*
  • Heart Diseases / physiopathology
  • Humans
  • Male
  • Myocardial Contraction
  • Ultrasonography, Doppler, Duplex*