Mobile atheromatous plaque at the origin of the internal carotid artery (ICA) is a rare finding on the carotid ultrasonography. Carotid ultrasonography is a noninvasive technique that is useful in defining the characteristics of plaques. Fifty -year-old male patient had multiple embolic infarction in the right hemisphere due to a flapping heterogeneous plaque at the right proximal ICA with moderate stenosis. Thereafter, he had taken received multiple medication including dual antiplatelet and high dose statin therapy. However, he had new neurological symptoms with new embolic infarctions on diffusion weighted MR imaging. Follow- up carotid ultrasound evaluation showed the disappearance of the previous mobile plaque. We conclude that the disruption and embolization of mobile component from carotid wall atheromatous plaque resulted in the recurrent infarction.

Journal of Neurosonology 6(1):20-23, 2014
Key Words: Mobile plaque, Carotid ultrasonography, Embolic infarction