Asymptomatic External Carotid Artery Thrombosis in Acute Stroke

Introduction

Spontaneous thrombosis of the external carotid artery seems to be extremely rare (Dominian et al. Br Med J 1959; 1: 554 – 555). Moreover, impaired blood flow of the external carotid artery, either due to thrombosis, atheromatous disease, ligation or secondary to internal carotid stenting, is associated with facial/neck pain or jaw claudication Herishanu et al. J Neurol Neurosurg, Psychiatry 1974; 37: 963 – 965; Lewis et al. Br Med J 1978; 2: 1611; Argentino et al. Ital J Neurol Sci 1980; 1: 271 – 274; Venna et al. Stroke 1986; 17: 325 – 327; Schiller et al. J Endovasc Ther 2007; 14: 304 – 306; Chen et al. J Vasc Surg 2011 (in press); Motamed et al. J Laryngol Otol 1998: 112: 73 – 74). In the setting of cardio-embolic stroke, vessel thrombosis mostly of the cerebral arteries, the internal carotid arteries or the vertebral arteries can be observed. Asymptomatic external carotid artery thrombosis has, to our knowledge, never been described in the acute stroke setting. In the case of acute stroke it might have an important diagnostic value since, in the absence of other pathologies, it confirms the suspected cardio-embolic origin.