Teaching NeuroImages: Vessel wall imaging of carotid web
Neethu Gopal, Vivek Gupta, Alok A. Bhatt, Erik H. Middlebrooks
Abstract
A 46-year-old man with a right distal middle cerebral artery occlusion was referred to a comprehensive stroke center. Outside CT angiogram (figure, A) had been originally interpreted as normal, but upon review revealed a carotid web at the origin of the right internal carotid artery. Catheter angiogram (figure, B) and MRI vessel wall imaging were subsequently performed (figure, C and D). Carotid web, a variant of fibromuscular dysplasia, is known to be thrombogenic due to stasis of blood flow distal to the web causing ipsilesional and recurrent infarctions.1,2 The appearance on MRI vessel wall imaging is currently not well-documented.
Topics & Concepts
Fibromuscular dysplasiaMedicineCarotid arteriesRadiologyStroke (engine)OcclusionCardiologyInternal medicineEngineeringMechanical engineeringRenal arteryKidneyRenal and Vascular PathologiesCerebrovascular and Carotid Artery DiseasesCongenital Heart Disease Studies