A 29-year-old man presented with a sudden motor weakness on the left hand, foot and face during sexual intercourse. A diffusion weighted MRI image revealed a high intensity spot on the right basal ganglia. A cerebral angiogram and three dimensional computed tomography of the cerebral artery demonstrated a marked stenosis and an intimal flap on the supraclinoid portion of the right internal carotid artery. He fully recovered and received antiplatelet drug medication without recurrence. Dissection of the internal carotid artery (ICA) is very rare, especially in the intracranial portion of the ICA, and in this case, collateral supply from the left internal carotid artery to the right hemisphere was sufficient to prevent neurological deficits.
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