Most cerebrovascular accidents (CVAs), commonly referred to as noncardiogenic strokes, occur as a result of atherosclerosis involving the common, internal and external carotids arteries, due to atheroma formation.Several factors influence atheroma formation, such as hypertension, smoking, diabetes mellitus, hypercholesterolemia, obesity and sedentary lifestyle among others. When atheromas are positioned inside the vessel lumen, they alter the flow of blood, causing the stroke. These atheromas, that are calcified plaques, can be observed in panoramic radiography. (J. Oral Sci. 45, 177-180, 2003) Key words: panoramic radiography; cerebrovascular accident; stroke, atheroma.Case Report A 68-year-old man came to the Radiology Clinic of the Piracicaba Dentistry School at the State University of Campinas for panoramic radiography screening prior to prosthetic treatment. Panoramic radiography showed several bilateral nodular radiopaque masses located inferior and posterior to the angle of the jaw, above the hyoid bone (Fig. 1). As the vertebral bodies were not visible, a further anteroposterior projection with the patient's mouth shut was taken, for the purpose of differential diagnosis. This radiograph verified that these masses were located in the intervertebral space between C3 and C4 (Fig. 2).Physical examination revealed no neck bruits and the patient reported no history of overt transient ischemic Correspondence to Dr. Flavio Ricardo Manzi,