Section Editor: Sandy Cheng-Yu Chen, M.D.
Taipei Medical University Hospital, Taipei, Taiwan
A carotid web clinically manifests as either recurrent ischemic stroke or recurrent transient ischemic attacks, especially in young patients. Carotid web is defined as a thin, linear membrane that extends from the posterior aspect of the ICA bulb into the lumen. Although a carotid web is considered histologically a variant of fibromuscular dysplasia (FMD), other radiographic evidence of FMD is often not appreciated. Carotid webs are highly thrombogenic and may be implicated in ischemic stroke. This occurs due to stasis of blood just distal to the web, resulting in thrombus formation, producing an embolic shower. In our case, the left carotid x-ray angiogram demonstrates a linear defect (A, arrow) in the proximal segment. Axial CT angiogram shows a similar defect (B, arrow). DWI shows acute stroke in left middle cerebral artery distribution (C, arrows).