Non-occlusive intraluminal internal carotid artery thrombus

Case contributed by Dr Chris O'Donnell

Presentation

Bilateral episodic amaurosis fugax (painless transient monocular visual loss)

Patient Data

Age: 65
Gender: Male

CT brain is normal so CT angiography performed

CT

Highly unusual intra-luminal filling defect (arrow) in the central right internal carotid artery distal to a high grade stenosis indicative of clot (it is too well-defined to represent "turbulent flow"). Small pieces are presumably breaking off to cause amaurosis. On the left there is a a large ulcerated plaque (without significant luminal narrowing) (arrow) presumably associated with thrombus in its base intermittently breaking off and reaching the retinal artery

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