A 70 year old man came with weakness of the right side for four hours which resolved over the next six hours without any intervention. There was a history of similar episodes with spontaneous resolution in the past two years.
CT angiography of the neck shows a near-complete lumen occluding thrombus in the cervical part of the left internal carotid artery, The thrombus has a narrow attachment to the arterial wall. A catheter angiogram of the left ICA shows critical stenosis at the origin of the left ICA with a floating thrombus in the lumen.