PT - JOURNAL ARTICLE AU - P.I. Sajedi AU - J.N. Gonzalez AU - C.A. Cronin AU - T. Kouo AU - A. Steven AU - J. Zhuo AU - O. Thompson AU - R. Castellani AU - S.J. Kittner AU - D. Gandhi AU - P. Raghavan TI - Carotid Bulb Webs as a Cause of “Cryptogenic” Ischemic Stroke AID - 10.3174/ajnr.A5208 DP - 2017 Jun 22 TA - American Journal of Neuroradiology 4099 - http://www.ajnr.org/content/early/2017/06/22/ajnr.A5208.short 4100 - http://www.ajnr.org/content/early/2017/06/22/ajnr.A5208.full AB - 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.