Teenage Male With Sudden Left Hemiparesis

Abstract

A 16-year-old previously healthy male adolescent was admitted to the ICU with sudden left hemiparesis. Head computed tomography result without contrast was normal, whereas magnetic resonance imaging showed an extensive right middle cerebral artery infarction. Magnetic resonance angiography found absence of flow within the right internal carotid artery from its origination to its distal portion, leading to suspicion of an extensive thrombosis of the right internal carotid artery (Figure 1). Further angiography performed within 48 hours of stroke symptoms revealed congenital absence of the internal carotid artery (Figure 2) and thrombosis of the right vertebral artery (Figure 3).