Focal adherent thrombus in the common carotid artery: clinical, ultrasonographic, and pathogenic aspects in two cases

Thrombi within the carotid artery usually occur in vessels with severe atherosclerotic lesions and may embolize to cause TIAs and ischemic brain infarctions. The risk factors and potential causes for carotid artery thrombus formation in the absence of atherosclerosis are currently only speculative (e.g., embolic occlusion from a cardiac source).1 Furthermore, a focal adherent thrombus involving the CCA is even more exceptional because of the rarity of severe atherosclerotic disease in this large and nonturbulent vessel.1,2 A thrombus lodged in the CCA has been reported in only a very few cases in the literature.2 We present two patients with a focal adherent thrombus in the CCA diagnosed by ultrasonography and confirmed by neuroimaging. The aim of this work is to investigate the ultrasonographic features of this very uncommon finding in young stroke patients.