The Floating Threat: A Rare Case Report of Carotid Saddle Thrombus in a Healthy Adult
Published Web Location
https://doi.org/10.5811/cpcem.48938
Abstract
Introduction: Carotid free-floating thrombus is a rare and potentially devastating cause of ischemic stroke. Diagnosis remains challenging due to the dynamic nature of the lesion.
Case Report: We report the case of a 46-year-old female presenting with neck pressure and gait instability, who was found to have a free-floating thrombus at the brachiocephalic-carotid junction. Despite early anticoagulation, she developed biparietal ischemic strokes.
Conclusion: This case highlights the challenges in management of carotid free-floating thrombus including appropriate anticoagulation, contraindications to thrombolysis, and the need for multidisciplinary involvement. Emergency physicians must maintain high suspicion for vascular pathology in atypical neurologic presentations and recognize that even optimal medical therapy does not eliminate stroke risk.