Abstract
Stenosis of an artery of more than 50% is usually regarded as significant stenosis, which may cause ischemic stroke. However, the nature of plaque may be important, even though the stenosis does not reach a significant degree. A 75-year old man with right arm weakness showed multiple scattered small infarct lesions at the left middle cerebral artery territory with mild stenosis of the left carotid artery. No embolic source was detected from cardiac assessments. Carotid duplex sonography showed a mobile plaque at the carotid artery, which was not detected by conventional angiography. Our case report suggests that direct vessel wall imaging can be useful in patients who have ischemic stroke with an embolic pattern without significant arterial stenosis. Key words: Carotid artery ulcerating plaque; Ultrasonography, Doppler, Duplex; Carotid artery thromboses
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