Recurrent cerebral ischaemic stroke in a Persian cat

Abstract A 4‐year‐old, 4.8 kg, male, neutered Persian cat was presented 12 hours following the acute onset of initially progressive, then subsequently improving, left‐sided weakness. Neurological examination revealed non‐ambulatory left‐sided hemiparesis. Postural reactions were absent in the left thoracic and pelvic limbs, and menace response was absent in the left eye. Neuroanatomical localisation was to the right forebrain, with multifocal involvement not excluded. Brain magnetic resonance imaging revealed a discrete T2 hyperintense intra‐axial lesion with restricted diffusion affecting the grey matter of the right frontal, temporal and piriform lobes. The most likely diagnosis was an ischaemic infarct of the parenchyma supplied by the right middle cerebral artery. The cat improved over 2 weeks, but 4 months later, experienced several transient abnormal episodes. Repeat imaging revealed a new lacunar ischaemic infarct within the territory of the left striate artery. Probable internal vertebral venous plexus and basilar sinus thromboses were also identified, suggestive of an underlying hypercoagulable state.