Capsular warning syndrome: report of a case.

The "capsular warning syndrome" (CWS) is characterized by recurrent stereotypical episodes of motor and/or sensory dysfunction without cortical signs. CWS is a clinically well recognized entity, and carries a significant risk of capsular infarct. The ischemia is most likely ascribable to hemodynamic changes in diseased small penetrating vessels. Treatment remains controversial and none has been proven effective. We described a 66-year-old man having 15 episodes of stereotypical transient ischemic attack within four days. The findings of the diffusion-weighted image showed abnormalities confined concurrently to the left lateral thalamus, posterior globus pallidus, and posterior corona radiata while the internal capsule was spared. Theses findings suggest involvement of the territory of anterior choroidal artery. We also documented changes in the pattern of attacks after initiation of intravenous urokinase.