RT Journal Article
SR Electronic
T1 Carotid Bulb Webs as a Cause of “Cryptogenic” Ischemic Stroke
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1399
OP 1404
DO 10.3174/ajnr.A5208
VO 38
IS 7
A1 Sajedi, P.I.
A1 Gonzalez, J.N.
A1 Cronin, C.A.
A1 Kouo, T.
A1 Steven, A.
A1 Zhuo, J.
A1 Thompson, O.
A1 Castellani, R.
A1 Kittner, S.J.
A1 Gandhi, D.
A1 Raghavan, P.
YR 2017
UL http://www.ajnr.org/content/38/7/1399.abstract
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.