%0 Journal Article %A P.I. Sajedi %A J.N. Gonzalez %A C.A. Cronin %A T. Kouo %A A. Steven %A J. Zhuo %A O. Thompson %A R. Castellani %A S.J. Kittner %A D. Gandhi %A P. Raghavan %T Carotid Bulb Webs as a Cause of “Cryptogenic” Ischemic Stroke %D 2017 %R 10.3174/ajnr.A5208 %J American Journal of Neuroradiology %X BACKGROUND AND PURPOSE: Carotid webs are intraluminal shelf-like filling defects at the carotid bulb with recently recognized implications in patients with recurrent ischemic stroke. We sought to determine whether carotid webs are an under-recognized cause of “cryptogenic” ischemic stroke and to estimate their prevalence in the general population.MATERIALS AND METHODS: A retrospective review of neck CTA studies in young patients with cryptogenic stroke over the past 6 years (n = 33) was performed to determine the prevalence of carotid webs compared with a control group of patients who received neck CTA studies for reasons other than ischemic stroke (n = 63).RESULTS: The prevalence of carotid webs in the cryptogenic stroke population was 21.2% (95% CI, 8.9%–38.9%). Patients with symptomatic carotid webs had a mean age of 38.9 years (range, 30–48 years) and were mostly African American (86%) and women (86%). In contrast, only 1.6% (95% CI, 0%–8.5%) of patients in the control group demonstrated a web. Our findings demonstrate a statistically significant association between carotid webs and ischemic stroke (OR = 16.7; 95% CI, 2.78–320.3; P = .01).CONCLUSIONS: Carotid webs exhibit a strong association with ischemic stroke, and their presence should be suspected in patients lacking other risk factors, particularly African American women. %U https://www.ajnr.org/content/ajnr/early/2017/06/22/ajnr.A5208.full.pdf