This 30 year old patient presented with transient limb weakness. He had suffered with similar episode 3 years ago, from which he had improved significantly. He was non-diabetic, but was hypertensive and heavy smoker. MRI with MR angiography, cerebral angiography and carotid showed a large floating thrombus in the internal carotid artery at its origin.
SURGERY: He underwent an emergency open carotid endarterectomy with excellent postoperative recovery. His limb weakness has not recurred or deteriorated since then.