Abstract

Background Symptomatic carotid web with retained thrombus represents a potential source of embolic strokes. However, the absence of diagnostic guidelines contributes to heterogeneity in management recommendations. Methods We present a patient with a right middle cerebral artery stroke attributable to carotid web with retained thrombus. Confirmation was obtained through surgical exploration, given the inconclusive imaging but strong index of suspicion. Results The presence of carotid web with retained thrombus was confirmed through surgical exploration. Cervical endarterectomy was performed and a carotid web with an associated thrombus was successfully resected. Conclusion We highlight the importance of having a high index of suspicion and prompt treatment to mitigate the risk of recurrent strokes when suspecting carotid web with retained thrombus.

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