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Carotid web

Case contributed by Corey Thompson
Diagnosis almost certain

Presentation

Unsteady gait with weakness on walking and altered sensation left side of face. Right carotid bruit.

Patient Data

Age: 65 years
Gender: Female

CTA Carotids

ct

Small thin smooth eccentric filling defect centered at the posterior wall of the right internal carotid artery origin without significant stenosis is in keeping with a carotid web.
No large vessel occlusion or dissection.
Hypoplastic left A1.
Symmetric atherosclerotic disease of the carotid syphon (left worse than right) without significant stenosis.
Bovine aortic arch.

Zoomed Key Image

ct

Arrow indicates right carotid web on oblique maximum intensity projection.

Case Discussion

Right internal carotid artery origin web without significant stenosis. These have the potential to be highly thrombogenic and a source of TIA and ischemic events.

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