Recurrent right hemiplegia associated with progressive ipsilateral carotid artery stenosis.

Abstract

Ipsilateral sensory motor symptoms associated with carotid artery stenosis are rare, and few reports are available in the literature. We report the case of a 50-year-old man who presented with right hemiplegia that recurred 14 months later. A left hemisphere watershed infarction was detected. Repeated angiograms showed a left internal carotid occlusion and a right internal carotid stenosis that initially measured 50% and worsened to 80% after the second stroke. Repeated quantitative measurements of cerebrovascular reserve demonstrated the hemodynamic mechanism of the strokes and the role of a right internal carotid lesion in causing the recurrence of right hemiplegia.