Unusual case of 2 renal cell carcinoma metastases ipsilateral to an occluded internal carotid artery.

Hemodynamic factors may play a role in the seeding and subsequent growth of cerebral metastasis. The authors present a case with 2 foci of cerebral metastasis in the same vascular territory ipsilateral to an occluded internal carotid artery. A 65-year-old man with chronic left frontal lobe infarct and left internal carotid artery occlusion was diagnosed with 2 large hemorrhagic metastases in the left middle cerebral artery territory. Diminished flow signals were seen in the trunk and branches of the left middle cerebral artery on magnetic resonance angiography. This case illustrates preferential seeding and growth of cerebral metastases in a region of the brain with diminished blood flow.