The etiology of ischaemic lesions of the central nervous system in younger patients remains obscure so far. Among the best known causes embolization, arterial dissection, inborn defects, vasculitis, impaired lipid metabolism may be mentioned. Case-record of an uncommon case: a 45-year-old man was admitted because of refractory headache, Horner’s syndrome on the left and an attack of expressive aphasia. Sonographic examination of the carotid arteries, transcranial coloured c oded sonography and panangiography of the brain revealed a long gradually narrowing stenosis of the internal carotid artery (ICA) on the left. After conservative treatment the patient improved and check-up sonography and CT angiography of the carotid arteries suggested regression of the originally filiform stenosis. Evaluation of the clinical findings and imaging methods led the authors to the conclusion that a long-term spasm of the left ICA in the cervical portion was involved, the etiology being unknown.

        Key words: internal carotid artery, vasospasm, cerebral ischaemia