Calcified Carotid Plaque - Source of Emboli
Calcified carotid plaques can serve as an embolic source in acute stroke. Although considered more stable than atheromateous plaque, their rupture could lead to vascular occlusion. Given their calcified nature, they are refractory to IV thrombolysis and their retrieval using interventional techniques is more challenging. Given their solid nature, it would not incorporate as a traditional clot would within the stent retriever and can get be pushed against the intimal wall as the stent opens.
These infarct follow the vascular territory of paramedian pontine perforators and are confined to midline.