The etiology of lacunar CCT lesions is controversial. We report a pati
ent with recurrent ischemia in the territory of the right internal car
otid artery. CCT initially showed a fresh non-lacunar lesion in the ar
ea of the basal ganglia and internal capsule. Subsequently, repeat CCT
revealed a singular lacunar defect in the internal capsule. The Doppl
er sonographic investigations showed an internal carotid artery occlus
ion. This case supports the hypothesis that an embolic or hemodynamic
etiology of the lacunae is possible.