Acidente vascular cerebral de etiologia rara com indica？？o cirúrgica urgente: caso clínico

19 years old patient with fever for 8 days associated with sudden aphasia, left hemiparesis and abnormal behavior. increased acute phase proteins in the analytical study. head ct scan and mri revealed a right temporo-parietal ischemic lesion. an echocardiogram excluded endocarditis. ultrasound and ct angiography scanning of the extracranial cerebral circulation showed a vegetative formation, mobile with the heartbeat, in the right common carotid artery. submitted, urgently, to carotid surgery. intraoperatively, a slightly adherent thrombus to the common carotid artery was found and in the dependence of an underlying injury to the intima. the thrombus was ressected and a primary arteriorrhaphy performed. it is pointed out a vasculitis secondary to hsv1 (active infection) or to rickettsia conorii infection as the most likely etiology of the clinic.