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Shyam Prabhakaran, MD; John W. Krakauer, MD

Arch Neurol. 2006;63:891-893.

Background  Subcortical transient ischemic attacks are usually seen in individuals with small-vessel disease. They are often refractory to medical treatment and progress to infarction in many cases.

Patient  We describe a young man with an unusual and protracted case of recurrent capsular ischemia due to postcoital middle cerebral artery dissection.

Conclusion  Spontaneous middle cerebral artery dissection should be considered in young patients presenting with subcortical transient ischemic attacks.

Author Affiliations: Stroke and Critical Care Division, The Neurological Institute, Columbia University, New York, NY.

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