Carotid Web Case Report: A Carotid Bifurcation Disorder Causing Stroke Without Localised Significant Stenosis

Carotid webs represent focal septum-like luminal protrusions, usually at the level of the ICA ostium. Strokes associated with carotid webs are considered rare, with an incidence of 0.7%-2.5%. However, the stroke re-occurrence rate in this population is 44% on best medical therapy. This case demonstrates the potential difficulty of discerning a web in the presence of thrombus on CTA, MRI and ultrasound. Furthermore, it highlights the high-risk properties of carotid webs for thrombus formation and as a potential cause of stroke. Carotid webs should be excluded as a potential cause of stroke, particularly in young and African populations where the incidence of carotid webs is suspected to be higher. Sonographer education specific to carotid webs is needed for accurate and timely detection of this rare disease.