Objective: The effectiveness of the urgent carotid TEA in patients with not stabilizes serious neurological symptomps, remains controversial. Material: The authors report on a case of a partial acute carotid thrombosis. The patient had outcomes of pulmonary tumor dealt with surgical removal of the medium right lobe. At admission, the neurological examination evidenced non specific neurological deficits to both the advanced limbs above all. The blood test evidenced 628000 platelets. The colordoppler showed in the internal carotid artery of right the presence of floating thrombus, during very small fibrocalcified plate, likely ulcerated. Results: The patient was submitted to surgical urgent procedure without ulterior diagnostic deepening. Such attitude was justified from the total regression of the symptomatology and from the absence of alterations of the BEE. Discussion: The urgent surgical treatment has had good outcome. In literature there are similar cases but not place upon ones because of “aetiology”: to the inner presence of floating thrombus in carotid not completely occluding in all and the three cases, causes do not correspond from alters platelet parameters, but thrombus was of cardiogenic origin in one case, it was caused by hormonal therapy for sterility in the second, there was trombosis of carotid aneurism in third. Conclusion: We remark the importance of ecocolor Doppler for urgent diagnosis of acute thrombosis, and timeliness of surgical treatement in the “acute” patient with attenuation or regression of the debut symptomatology.