Persistent Cephalgia Secondary to Carotid Web

Introduction

The Carotid Web (CW) consists of an intraluminal projection of the carotid artery’s intima, forming either as a membrane or tissue fold, and may cause arterial lumen stenosis, disrupt blood flow patterns, leading to vascular embolic events such as a Cerebrovascular Accident (CVA). The Carotid Web can be asymptomatic or symptomatic, with symptoms most often presenting as persistent cephalgia (headache). CW is a congenital anomaly of embryological development at the carotid bifurcation level. Currently, due to technological advances, CW is more easily diagnosed through the following diagnostic methods: Color Doppler Echocardiography (CDE), Computed Tomography Angiography (CTA), Magnetic Resonance Angiography (MRA) and Angiography (AGP). CDE is a highly accurate exam, demonstrating high sensitivity (94%) and specificity (92%). However, its positive and negative predictive values can be influenced by the disease’s low prevalence, making the exam highly reliant on a qualified, experienced examiner.,,,,,,

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