Right Hemiparesis in Right Carotid Stenosis

A 72-year-old right-handed man with a history of hypertension and past smoking, taking low-dose aspirin therapy (100 mg once a day) for cardiovascular prevention, presented with sudden onset of right hemiparesis and confusion. The right hemiparesis improved during the following days, but the patient was still confused. He arrived at the emergency department 6 days after the onset of symptoms. On neurological examination, the patient showed mild disorientation both in time and in place; no other neurological signs could be elicited. Blood pressure was 160/90 mm Hg. Blood count, prothrombin time, activated thromboplastin time, ionogram, C-reactive protein, troponin Ic, and creatine kinase were normal. ECG revealed normal sinus rhythm (76 bpm). Extracranial …