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INTRODUCTION: We report the case of a patient with distal migration of a floating carotid thrombus caused by oral contraceptives. CASE PRESENTATION: A 48-year-old woman using oral contraceptives suffered from dysarthria and gait disturbance. Examinations, including ultrasound and cerebral arteriogram, revealed a floating thrombus at the left carotid bifurcation with no stenosis. Despite antithrombotic therapy, the floating carotid thrombus migrated to the ipsilateral middle cerebral artery, resulting in a severe stroke. CONCLUSION: Some floating thrombi are resistant to conservative therapy and have a risk of distal migration, which may cause a major stroke in the acute stage.
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Watanabe et al. (2009) studied this question.
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