Man Gao1, Jing Lei2. 1. Department of Neuroradioloy, Tianjin Huanhu Hospital, No. 6 Ji Zhao Road, Jin Nan District, Tianjin, 300350, China. 13622008916@163.com. 2. Department of Neuroradioloy, Tianjin Huanhu Hospital, No. 6 Ji Zhao Road, Jin Nan District, Tianjin, 300350, China.
Abstract
BACKGROUND: A carotid web is a very rare vascular disease of the carotid artery, leading to thrombosis and ischemic stroke. CASE PRESENTATION: A 65-year-old male patient was admitted due to left limb weakness. On arrival, he had moderate left hemiplegia, neglect, and sensory loss; the National Institutes of Health Stroke Scale score was 8. Computed tomography angiography (CTA) and magnetic resonance (MR) examination were performed to determine the cause of basal ganglia infarction. Thin-section axial CTA showed a membrane-like structure in the posterior wall of the right common carotid artery. The sagittal reconstruction image showed a membrane-like protrusion in the posterior wall of the right common carotid artery under the right carotid sinus. The MR axial T2 image showed a membrane-like high-signal protrusion into the carotid artery lumen, which was diagnosed as a right carotid web. The patient was treated with dual antihypertensive therapy by adjusting blood pressure, controlling brain edema, improving cerebral circulation, and nourishing the nerves. CONCLUSION: Careful comparison of axial thin-layer CTA and MR axial T2 images combined with sagittal reconstruction of CTA images can greatly improve the diagnostic rate of carotid web.
BACKGROUND: A carotid web is a very rare vascular disease of the carotid artery, leading to thrombosis and ischemic stroke. CASE PRESENTATION: A 65-year-old male patient was admitted due to left limb weakness. On arrival, he had moderate left hemiplegia, neglect, and sensory loss; the National Institutes of Health Stroke Scale score was 8. Computed tomography angiography (CTA) and magnetic resonance (MR) examination were performed to determine the cause of basal ganglia infarction. Thin-section axial CTA showed a membrane-like structure in the posterior wall of the right common carotid artery. The sagittal reconstruction image showed a membrane-like protrusion in the posterior wall of the right common carotid artery under the right carotid sinus. The MR axial T2 image showed a membrane-like high-signal protrusion into the carotid artery lumen, which was diagnosed as a right carotid web. The patient was treated with dual antihypertensive therapy by adjusting blood pressure, controlling brain edema, improving cerebral circulation, and nourishing the nerves. CONCLUSION: Careful comparison of axial thin-layer CTA and MR axial T2 images combined with sagittal reconstruction of CTA images can greatly improve the diagnostic rate of carotid web.
Entities:
Keywords:
CTA; Carotid web; Common carotid artery; Stroke
Authors: Jeffrey W Olin; James Froehlich; Xiaokui Gu; J Michael Bacharach; Kim Eagle; Bruce H Gray; Michael R Jaff; Esther S H Kim; Pam Mace; Alan H Matsumoto; Robert D McBane; Eva Kline-Rogers; Christopher J White; Heather L Gornik Journal: Circulation Date: 2012-05-21 Impact factor: 29.690
Authors: P I Sajedi; J N Gonzalez; C A Cronin; T Kouo; A Steven; J Zhuo; O Thompson; R Castellani; S J Kittner; D Gandhi; P Raghavan Journal: AJNR Am J Neuroradiol Date: 2017-05-11 Impact factor: 3.825