Image and clinical analysis of common carotid web: a case report

BACKGROUND: A carotid web is a very rare vascular disease of the carotid artery, leading to thrombosis and ischemic stroke. CASE PRESENTATION: A 65-year-old male patient was admitted due to left limb weakness. On arrival, he had moderate left hemiplegia, neglect, and sensory loss; the National Institutes of Health Stroke Scale score was 8. Computed tomography angiography (CTA) and magnetic resonance (MR) examination were performed to determine the cause of basal ganglia infarction. Thin-section axial CTA showed a membrane-like structure in the posterior wall of the right common carotid artery. The sagittal reconstruction image showed a membrane-like protrusion in the posterior wall of the right common carotid artery under the right carotid sinus. The MR axial T2 image showed a membrane-like high-signal protrusion into the carotid artery lumen, which was diagnosed as a right carotid web. The patient was treated with dual antihypertensive therapy by adjusting blood pressure, controlling brain edema, improving cerebral circulation, and nourishing the nerves. CONCLUSION: Careful comparison of axial thin-layer CTA and MR axial T2 images combined with sagittal reconstruction of CTA images can greatly improve the diagnostic rate of carotid web.