Lacunar Infarction and Carotid Artery Stenosis: A Case Report

This report describes a 56-year-old male patient admitted to the hospital with a one-day history of headache and abnormal mental behavior. The patient exhibited forgetfulness, such as leaving the faucet running, and disorientation, including difficulty recognizing zebra crossings. Physical examination revealed weakness and occasional numbness in the left hand.

An MRI examination showed acute lacunar infarction in the right caudate nucleus. A routine ultrasound examination revealed a slightly hypoechoic plaque at the bifurcation of the right common carotid artery and the beginning of the internal carotid artery, causing stenosis of the beginning segment of the internal carotid artery. The maximum flow velocity at the stenosis was approximately 272 cm/s, and the flow velocity near the proximal end of the stenosis was about 81 cm/s. The ICA/CCA PSV ratio was 3.36, and according to the NASCET standard, the diameter stenosis rate was approximately 58.4%.

This case highlights the association between carotid artery stenosis and lacunar infarction. The patient's symptoms, imaging findings, and carotid ultrasound results suggest that the lacunar infarction may be related to the significant stenosis in the right internal carotid artery. This case emphasizes the importance of thorough evaluation and early detection of carotid artery disease in patients presenting with neurological symptoms, even those seemingly minor or transient.

Lacunar Infarction and Carotid Artery Stenosis: A Case Report