Compensatory Hemodynamics in Severe Unilateral Internal Carotid Artery Stenosis: A Case Report

Introduction: Severe internal carotid artery stenosis can cause significant changes in hemodynamics, altering cerebral perfusion. Case Presentation: We present the case of a 68-year-old male who presented with intermittent limb weakness, aphasia, and dizziness, with no history of recent trauma or syncopal episodes. He was diagnosed with severe unilateral internal carotid artery stenosis due to an atherosclerotic plaque. This report highlights alterations in blood flow velocities in the bilateral extracranial arteries, assessed using duplex ultrasound. Notably, increased flow velocities were observed in the ipsilateral external carotid and vertebral arteries compared to the contralateral side. These findings emphasize the importance of assessing compensatory blood flow adaptations in patients with severe internal carotid artery stenosis, which can aid in risk stratification, optimize medical management, and guide decisions regarding vascular intervention. Conclusions: This case report highlights careful bilateral assessment of blood flow velocities in the extracranial arteries as an effective method for monitoring patients with severe extracranial artery stenosis.