{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:27:50Z","timestamp":1783434470389,"version":"3.54.6"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Carotid stump syndrome (CSS) is a rare and unexpected cause of recurrent ischemic ipsilateral events in the carotid vascular territory despite the demonstrated occlusion of the internal carotid artery (ICA). It is believed to be caused by microemboli due to turbulent blood flow in the patent stump of the occluded ICA that passes through anastomotic channels and retrograde flow into the middle cerebral artery circulation. Case Presentation: We describe the case of a 65-year-old male patient who suffered multiple concurrent transient ischemic attacks (TIAs) with a totally occluded ipsilateral ICA revealed by computed tomography angiography (CTA). He was diagnosed with CSS, which required the safest therapeutic approach. A further investigation with digital subtraction angiography (DSA) was performed, and a trickle of blood flow was observed in the reportedly occluded ICA. The diagnosis of a true ICA occlusion was withdrawn, and a diagnosis of pseudo-occlusion was established, affecting the final treatment strategy. Therefore, the patient underwent an ipsilateral carotid endarterectomy (CEA), and he has remained asymptomatic since then. Conclusions: The differentiation between a pseudo-occlusion and a true ICA occlusion is essential in promptly managing acute recurrent ipsilateral ischemic strokes in the carotid vascular territory. A further investigation with DSA in cases with a totally occluded ICA using CTA is essential for excluding pseudo-occlusions in ipsilaterally symptomatic patients.<\/jats:p>","DOI":"10.3390\/diagnostics15101273","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T03:51:03Z","timestamp":1747626663000},"page":"1273","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Carotid Stump Syndrome: A Case That Highlights the Necessity of Digital Subtraction Angiography for the Prompt Management of the Syndrome"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0876-2099","authenticated-orcid":false,"given":"Christos","family":"Stenos","sequence":"first","affiliation":[{"name":"2nd Neurological Department, Henry Dunant Hospital Center, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5405-4237","authenticated-orcid":false,"given":"Aikaterini","family":"Anastasiou","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Nikolopoulou","sequence":"additional","affiliation":[{"name":"2nd Neurological Department, Henry Dunant Hospital Center, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Papanagiotou","sequence":"additional","affiliation":[{"name":"2nd Neurological Department, Henry Dunant Hospital Center, 11526 Athens, Greece"},{"name":"Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte\/Bremen-Ost, 28325 Bremen, Germany"},{"name":"1st Department of Radiology, School of Medicine, National & Kapodistrian University of Athens, Areteion Hospital, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-1031","authenticated-orcid":false,"given":"Georgios","family":"Papagiannis","sequence":"additional","affiliation":[{"name":"Biomechanics Laboratory, Physiotherapy Department, University of the Peloponnese, 23100 Sparta, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Koutroumpi","sequence":"additional","affiliation":[{"name":"2nd Neurological Department, Henry Dunant Hospital Center, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danai","family":"Drakopoulou","sequence":"additional","affiliation":[{"name":"2nd Neurological Department, Henry Dunant Hospital Center, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Periklis","family":"Anastasiou","sequence":"additional","affiliation":[{"name":"Medical School, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4876-4566","authenticated-orcid":false,"given":"Konstantina","family":"Yiannopoulou","sequence":"additional","affiliation":[{"name":"2nd Neurological Department, Henry Dunant Hospital Center, 11526 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1161\/CIRCRESAHA.117.310138","article-title":"Stroke Caused by Extracranial Disease","volume":"120","author":"Barrett","year":"2017","journal-title":"Circ. 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India"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/10\/1273\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:34:20Z","timestamp":1760031260000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/10\/1273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,17]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["diagnostics15101273"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15101273","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,17]]}}}