Idiopathic free-floating thrombus of the common carotid artery.
BACKGROUND
The observation of an intraluminal common carotid artery thrombus overlying a wall defect at ultrasonography or angiography is unusual. To our knowledge, there are no previous reports of a free-floating thrombus in the common carotid artery.


METHODS
A 45-year-old woman who was previously healthy and on no medications presented with acute hemiparesis and aphasia. Following testing that included carotid duplex and transcranial Doppler ultrasonography, diffusion-weighted magnetic resonance imaging, and digital subtraction angiography, the patient underwent emergency open embolectomy. No underlying wall defect was seen at the time of imaging or surgery. No obvious hypercoagulable state could be identified. Her NIH Stroke Scale score improved from 26 at admission to 2 at three months and 1 at one year.


CONCLUSIONS
Multimodal imaging may have improved diagnosis and management in this patient with a unique finding. The source of the thrombus remains obscure.
Silver
Brian
B
Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA.
Gulka
Irene
I
Nicolle
Michael
M
Sahjpaul
Ramesh
R
Hachinski
Vladimir
V
D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013927:Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography