Carotid Web on Ultrasound: Signs and Association with Cryptogenic Stroke
The topic of the 'carotid web' as an independent nosological entity is not separately disclosed in the provided source fragments. Direct ultrasound signs of the web, its morphometric criteria, and statistical association with cryptogenic stroke are absent in the available materials [clarify].
Context: Non-stenotic Lesions and Cryptogenic Stroke
The fragments indicate the significance of non-stenotic carotid plaque in cryptogenic embolic stroke (Siegler JE. The attributable risk of nonstenotic cervical carotid plaque in cryptogenic embolic stroke. Stroke Vasc Interv Neurol. 2023;3(4):e000727). This underscores the role of cervical carotid artery lesions without hemodynamically significant stenosis as a source of embolism—a concept that includes the carotid web; however, specific data on the web are not provided in the source [clarify].
Underestimated Non-atherosclerotic Causes of TIA/Stroke
The source highlights the arterial (stylo-carotid) variant of Eagle syndrome as one of the underestimated causes of TIA/stroke in patients without atherosclerosis, especially young ones. Mechanism: contact of the styloid process with the carotid artery wall (more often ICA), position-dependent compression, with repeated trauma leading to intimal damage up to dissection, mural thrombus, and embolism; symptoms are provoked by turning or extending the head.
This example illustrates the general principle: in young patients with cryptogenic stroke, non-atherosclerotic vascular causes at the neck level should be specifically sought. Extrapolating these data directly to the carotid web without corresponding fragments is inadmissible [clarify].
Assessment of Carotid Wall Morphology and Surface on Ultrasound
For characterizing the surface of carotid lesions, the source provides the following data:
| Parameter | Value from Fragments |
|---|---|
| Ulcer Criteria (Niche) | ≥2 mm in depth and width |
| Surface Classification | smooth / irregular 0.3–0.9 mm / ulceration |
| Sensitivity of CEUS to Ulcer | ~88% versus ~29% with conventional ultrasound |
The mentioned indicators relate to the assessment of atherosclerotic plaque vulnerability, not to the diagnosis of a carotid web; applying them to the web is not permissible [clarify].
Frequently asked questions
Are there ultrasound criteria for the carotid web in the source?
No. In the provided fragments, separate ultrasound signs and morphometric criteria for the carotid web are not described [clarify].
Is the association of the web with cryptogenic stroke confirmed in the fragments?
Not directly. Only the significance of non-stenotic carotid plaque in cryptogenic embolic stroke is indicated (Siegler JE, 2023); specific data on the web are not available [clarify].
What non-atherosclerotic causes of stroke in young people are mentioned?
The arterial (stylo-carotid) variant of Eagle syndrome: compression of the ICA by the styloid process with intimal damage, dissection, mural thrombus, and embolism, provoked by turning/extending the head.
What criteria for surface ulceration are provided in the source?
Niche ≥2 mm in depth and width; the surface is classified as smooth, irregular (0.3–0.9 mm), or ulceration. These criteria relate to atherosclerotic plaque.
Which method enhances the detection of surface ulceration?
Contrast-enhanced ultrasound (CEUS): sensitivity to ulceration ~88% versus ~29% with standard examination (Front Cardiovasc Med, 2022).