Histopathological Examination of a Symptomatic Carotid Web: A Case Report

• Published in: NMC Case Report Journal Vol. 11; pp. 69 - 74
• Main Authors: ARAI, Yukika, CHO, Junshi, FUJINO, Asuka, TAIRA, Naoki, KUNIEDA, Junko, KOIKE, Morio
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 31-12-2024
• Subjects: carotid endarterectomy; carotid web; Case Report; cerebral ischemia; stroke; stroke in young adults; carotid endarterectomy; carotid web; stroke in young adults; stroke; cerebral ischemia
• ISSN: 2188-4226; 2188-4226
• DOI: 10.2176/jns-nmc.2023-0181

Carotid webs cause ischemic stroke in young people and are associated with a high rate of stroke recurrence. Histopathological examination is crucial for clarifying the pathogenesis and mechanisms underlying the occurrence of carotid webs, although the mechanisms generally remain unclear. Here, we report a case of a symptomatic carotid web in a woman in her 50s who had a medical history of two ischemic strokes. She was diagnosed with a right carotid web and underwent carotid endarterectomy 18 days after the second stroke. Histopathological examination clearly revealed several phases of intimal hyperplasia. Furthermore, a thrombus attached to the carotid web showed invasion by fibroblasts and capillaries, and organization had begun. We presume that after the appearance of the carotid web, the thrombus formed by stagnant flow and became organized, causing the carotid web to grow and change in shape.