Image and clinical analysis of common carotid web: a case report

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.

A case of carotid web: Cause of stroke in healthy and young patients

“…Magnetic resonance angiography, although superior in delineating vessel wall anatomy, has lower sensitivity and specificity compared with CTA and DSA. 3,4,6 At ultrasound, carotid webs appear as echogenic intimal projections from the posterior carotid bulb, which are less reliably distinguished from atherosclerotic plaques. 6 However, the degree of stenosis is more accurately determined by ultrasonography and haemodynamic alterations are better assessed using Doppler.…”

“…Therefore, oblique sagittal views obtained by CTA multiplanar reformats are the best tool for identification. 1,2,3,4 Carotid dissection, focal atherosclerotic plaques (FAP) and typical FMD are the imaging mimics of carotid webs. 2,3 Focal atherosclerotic plaque appears as an irregular concentric calcification or hypoattenuating wall thickening, causing variable degrees of luminal stenosis and proportional velocity changes on Doppler, findings, which are not seen with a carotid web.…”

Carotid Web Stent for the Prevention of Recurrent Stroke: Case report and literature review

“…Flow abnormality suggestive of turbulent flow pattern was seen on 2D TOF images (11). Another case reported the finding of hyperintense film-like lesion on T2 images (12).…”

Adversarial Attack and Defence through Adversarial Training and Feature Fusion for Diabetic Retinopathy Recognition

“…Universal perturbations attacks (UPA), which used iterative algorithms for targeted and non-targeted attacks, were proposed by [ 56 ], and achieved 80% accuracy in classification. Reference [ 57 ] presented two lightweight techniques, which used local perturbation and universal attacks.…”