• P I Sajedi, J N Gonzalez, C A Cronin, T Kouo, A Steven, J Zhuo, O Thompson, R Castellani, S J Kittner, D Gandhi, and P Raghavan.
• From the Departments of Diagnostic Radiology and Nuclear Medicine (P.R., P.I.S., T.K., J.Z.).
• AJNR Am J Neuroradiol. 2017 Jul 1; 38 (7): 1399-1404.

Background And PurposeCarotid webs are intraluminal shelf-like filling defects at the carotid bulb with recently recognized implications in patients with recurrent ischemic stroke. We sought to determine whether carotid webs are an under-recognized cause of "cryptogenic" ischemic stroke and to estimate their prevalence in the general population.Materials And MethodsA retrospective review of neck CTA studies in young patients with cryptogenic stroke over the past 6 years (n = 33) was performed to determine the prevalence of carotid webs compared with a control group of patients who received neck CTA studies for reasons other than ischemic stroke (n = 63).ResultsThe prevalence of carotid webs in the cryptogenic stroke population was 21.2% (95% CI, 8.9%-38.9%). Patients with symptomatic carotid webs had a mean age of 38.9 years (range, 30-48 years) and were mostly African American (86%) and women (86%). In contrast, only 1.6% (95% CI, 0%-8.5%) of patients in the control group demonstrated a web. Our findings demonstrate a statistically significant association between carotid webs and ischemic stroke (OR = 16.7; 95% CI, 2.78-320.3; P = .01).ConclusionsCarotid webs exhibit a strong association with ischemic stroke, and their presence should be suspected in patients lacking other risk factors, particularly African American women.© 2017 by American Journal of Neuroradiology.

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