I would really appreciate your opinions on the following. We see calcified carotid atheromas (CCA) in the neck on a regular basis as incidental findings in (maxillofacial) cone-beam CT scans of our patients. Sometimes we also see intracranial calcification in the wall of the internal carotid artery (in the carotid sulcus), usually in addition to calcifications in the neck. Considering the potential increased risk for stroke, we recommend that patients with CCA in the neck are referred to the physician for further testing (ultrasound). Occasionally, we only see intracranial calcification in the ICA without calcifications in the neck. What should be our recommendation for patient management in these cases?
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T.T. de Weert, H. Cakir, S. Rozie, S. Cretier, E. Meijering, D.W.J. Dippel, and A. van der Lugt. Intracranial Internal Carotid Artery Calcifications: Association with Vascular Risk Factors and Ischemic Cerebrovascular Disease. AJNR Am. J. Neuroradiol., Jan 2009; 30: 177 – 184.