Esha Himmat Meherwal¹*, Vivek Murumkar², Priscilla Joshi³ and Sankar Prasad Gorthi⁴

¹Junior Resident, Department of Radiodiagnosis, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
²Assistant Professor, Department of Radiodiagnosis, Neurointervention Specialist, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
³Professor and Head of Department, Department of Radiodiagnosis, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
⁴Professor and Head of Department, Department of Neurology, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India

*Corresponding Author: Esha Himmat Meherwal, Junior Resident, Department of Radiodiagnosis, Bharati Vidyapeeth Deemed University Medical College and Hospi- tal, Pune, India.

Received: March 30, 2026; Published: May 31, 2026

Abstract

This case report describes an unusual presentation of a carotid web (CaW) causing hemodynamic stroke in a 63-year-old hypertensive male, diverging from the typical thromboembolic mechanism commonly seen in younger patients. The patient presented with recurrent transient neurological deficits and was found to have left-sided watershed infarcts. Advanced imaging confirmed a CaW at the left carotid bulb causing severe flow restriction, evidenced by turbulent flow (“whirlpool sign”) on Doppler and dynamic obstruction on Digital Subtraction Angiography (DSA), notably without thrombus formation. The patient was successfully treated with endovascular stenting of the left internal carotid artery (ICA), which restored normal cerebral blood flow and resulted in complete resolution of symptoms at the 3month follow-up. This case highlights the clinical variability of carotid webs, emphasizing that they can cause recurrent strokes via hemodynamic compromise rather than embolism, and confirms stenting as an effective management strategy for this atypical presentation.

Keywords: Ischemic Stroke; Carotid Web (CaW); Digital Subtraction Angiography (DSA)

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Citation

Citation: Esha Himmat Meherwal., et al. “Carotid Web As A Rare Cause of Recurrent Ischemic Stroke: A Hemodynamic Phenomenon without Thrombo- embolism". Acta Scientific Neurology 9.6 (2026): 31-37.

Copyright

Copyright: ©2026 Esha Himmat Meherwal., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.