A free-floating internal carotid artery thrombus and acute ischemic stroke: A case report for a rare condition with therapeutic challenges

Acute management of stroke with carotid free-floating thrombus (FFT) needs careful monitoring to proactively prevent the additional risk of infarction, and reducing intracranial bleeding is the primary goal. No management guidelines are available for this rare clinical condition. Here we presented a case study of a patient presenting with a carotid FFT with acute left-sided weakness. The patient was managed with anticoagulation alone, and the patient was discharged to return home in stable condition and good functional status with mild disability in the patient's left arm. In conclusion, carotid FFT is a rare clinical condition with underlying heterogeneous etiologies and individual-level bleeding risk stratification. Medical and surgical options are considered on a case-by-case basis.