2025 Volume 47 Issue 3 Pages 165-169
A 67-year-old man, diagnosed with embolic stroke of undetermined source 2 years ago, was on aspirin for secondary prevention. He presented with dysarthria and was found to have a new infarction in the right frontal lobe. CT angiogram (CTA) revealed a carotid web (CW) at the origin of the right internal carotid artery, and he was diagnosed with cerebral embolism due to the CW. Despite antiplatelet therapy, he experienced rapid morphological changes in the CW and recurrent cerebral infarction. He underwent carotid artery stenting under dual antiplatelet therapy. Even in CWs without recurrent cerebral infarction for 2 years with antiplatelet therapy, dynamic morphological changes can occur rapidly, leading to recurrent cerebral infarction. Therefore, close imaging follow-up with CTA should be performed, and prompt revascularization is necessary when changes are observed.
