title: Carotid free-floating thrombus causing stroke in a young woman with lupus anticoagulant: A case report and review of the literature.
abstract: BACKGROUND
  In young adults Stroke is a challenging condition and various tests are needed to diagnose and manage its underlying problems. Free floating thrombosis of internal carotid artery (FFT-ICA) is one of the rare problems among carotid artery diseases which can lead to stroke in adults. Owing to limited cases of FFT-ICA there is not a worldwide accepted consensus on management of FFT-ICA, but some recurrences after medical management have been reported in the literature.
  
  
  METHODS
  A-25-year old woman was referred to hospital with sudden onset aphasia and right sided hemiparesis. Carotid duplex ultrasonography showed an iso-echogenic thrombus ranged about 5×10mm partially attached to arterial wall of the right internal carotid artery. It was floating in accordance with the heartbeat. Anticoagulation therapy was initiated and subsequently she underwent an urgent operation. To explore the etiology of her problem, various lab tests were carried out; the results showed markedly elevated levels of lupus anticoagulant. She was discharged from hospital after an uneventful recovery showing gradual improvement of symptoms in follow-up visits.
  
  
  CONCLUSIONS
  FFT-ICA is one of the scarce disorders of carotid artery. Less than 150 cases have been reported in the literature indicating its common occurrence in old men. Hence the etiology of this case (FFT in a young patient with high levels of lupus anticoagulant antibody) may be the first of its type.
  
  
  CONCLUSIONS
  In this case we chose surgical treatment resulting in complete resolution of symptoms and non-recurrence within 6 month follow-up.
authors.affiliation: General and Vascular Surgery, Shohada Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: aafsharfard@Gmail.com.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Afsharfard
authors.affiliation: General Surgery, Shahid Modarres Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: barmak.gholizadeh@Gmail.com.
authors.forename: Barmak
authors.initials: B
authors.lastname: Gholizadeh
authors.affiliation: Vascular Surgery, Shohada Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: Y_abdolalian@yahoo.com.
authors.forename: Younes
authors.initials: Y
authors.lastname: Abdolalian
authors.affiliation: General Surgery, Shahid Modarres Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mdhosseini63@Gmail.com.
authors.forename: Seyed Masoud
authors.initials: SM
authors.lastname: Hosseini
keywords: Carotid arteries; Case report; Lupus coagulation inhibitor; Stroke; Thrombosis