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Carotid plaque ulceration is a major risk factor for stroke and correlates with embolic signals on transcranial Doppler ultrasound, regardless of the degree of stenosis.
Ulcerated surface is defined as a surface recess with depth measuring more than 1 mm or 2 mm in depth, according to different studies and proposed risk stratification systems, seen along the contour of the lesion. Other criteria De Bray 1997 of ulceration are:
The recess:
1. must be at least more than 2 mm deep and 2 mm in length
2. must have a well-defined wall at its base
3. must exhibit an area of reversed flow, without frequency aliasing, or a zone of low flow signal on colour flow Doppler.
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