PT  - JOURNAL ARTICLE
AU  - Sajedi, P.I.
AU  - Gonzalez, J.N.
AU  - Cronin, C.A.
AU  - Kouo, T.
AU  - Steven, A.
AU  - Zhuo, J.
AU  - Thompson, O.
AU  - Castellani, R.
AU  - Kittner, S.J.
AU  - Gandhi, D.
AU  - Raghavan, P.
TI  - Carotid Bulb Webs as a Cause of “Cryptogenic” Ischemic Stroke
AID  - 10.3174/ajnr.A5208
DP  - 2017 Jul 01
TA  - American Journal of Neuroradiology
PG  - 1399--1404
VI  - 38
IP  - 7
4099  - http://www.ajnr.org/content/38/7/1399.short
4100  - http://www.ajnr.org/content/38/7/1399.full
SO  - Am. J. Neuroradiol.2017 Jul 01; 38
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.