A 70-year-old man without cerebrovascular risk factors was admitted to our hospital with amaurosis fugax of the right eye. Diffusion MRI showed an acute asymptomatic brain infarct in the right frontal lobe cortex, and carotid duplex ultrasound revealed movement of the right internal carotid artery (ICA), with a hypoechoic plaque at its origin, in contact with the hyoid bone during head rotation and swallowing (figure).

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