Objective:

To evaluate baseline characteristics and comorbidities associated with carotid web in young stroke. 

Background:

Carotid webs are increasingly recognized cause of first and recurrent stroke in the young. Carotid webs are non-atherosclerotic and non-inflammatory shelf-like intraluminal protrusions in the carotid bulb. There are relatively limited data on the race, sex, and risk factor profile of these patients.

Design/Methods:

We conducted a retrospective review of stroke patients between the ages of 18 to 50 years presenting to our Young Stroke Center between April 2022 through August 2023. For each case, data including basic demographics and medical history were collected, and stroke etiology was determined by a vascular neurologist. Patients with carotid web as the stoke etiology were compared to all non-carotid web stroke etiologies with respect to baseline demographics and comorbidities including hypertension, dyslipidemia, diabetes, smoking, and obesity. Analysis was performed with logistic regression adjusting for age, sex, and race.

Results:

Of 179 patients in the registry, 9 patients had carotid web compared with 170 patients with non-carotid web as their stroke etiology. There were no significant differences in age at time of stroke (41.6 ± 5.5 vs. 38.5 ± 8.0 years).  The carotid web group had a higher proportion of females, but this was not statistically significant (88.9% vs. 61.8% female, p=0.11). In the carotid web group, there were 8 Black and 1 non-Black Asian patients which was significantly different compared to the non-carotid web group (88.9% vs. 52.4% Black; p=0.03). A significantly larger proportion of patients with carotid web presented with no baseline cardiovascular risk factors (77.8% vs. 17.7%; OR [95% CI]: 35.7 [5.6-229]).

Conclusions:

In the young stroke population, strokes attributed to carotid webs occur independently of typical stroke comorbidities. Additionally, Black patients are disproportionately affected and there is a trend toward increased incidence of strokes due to carotid webs in women.