Carotid Web-Like Intraplaque Flow Stasis Case Report: A Potential Novel Stroke Mechanism

BACKGROUND Non-stenotic carotid atheromatous disease (SyNC) and carotid webs (CaW) are increasingly recognised aetiologies of ischaemic stroke. We present a potential novel stroke mechanism from non-stenotic carotid atheromatous disease. CASE PRESENTATION We report a 77-year-old patient with recurrent internal carotid artery-territory embolic strokes over a decade in the context of a non-stenotic, chronically ulcerated left internal carotid artery atherosclerotic plaque. Focal stasis within the ulcerated plaque was the probable mechanism, analogous to carotid web. CONCLUSION Stasis of flow within plaque ulceration may be a previously unrecognised stenting-responsive stroke mechanism, in both stenotic and non-stenotic carotid atherosclerosis.