Background: Woven-like arteries represent a rare congenital vascular variation with only a handful of cases documenting for coronary arteries. The standard diagnostic approach employs angiographic imaging. This vascular anomaly often mimics other vascular diseases, such as stenosis, dissection, or recanalization following a thrombotic occlusion. Accurate differential diagnosis of such woven-like lesions plays an important role in defining treatment strategies.
Case presentation: A 62-year-old female presented with intermittent numbness and weakness on her right side. She was diagnosed with transient ischemic attack, which was associated with woven-like changes in the ipsilateral internal carotid artery revealed by cerebral angiography. Following the diagnosis, the patient was started on secondary preventative strategy to mitigate the risk of an ischemic stroke. Over a follow-up period of 2 years, the patient showed no significant signs of a cerebrovascular event.
Conclusions: To our knowledge, this case presents the first recorded instance of a woven-like change in the internal carotid artery. Identification of this rare vascular anomaly is of great clinical significance. This case underscores the importance of including rare vascular variations in the differential diagnosis to help make effective and personalized patient management choices.