Hypoplastic Internal Carotid Artery in a Young Stroke Patient

Background: Hypoplastic internal carotid artery (HICA) is a rare congenital vascular anomaly, typically asymptomatic due to collateral circulation. However, in certain cases, it may present with ischemic stroke. Case Presentation: We report a 17-year-old male with a history of smoking and illicit drug use who presented with acute left-sided weakness. Imaging revealed an infarct in the right middle cerebral artery territory and a hypoplastic right internal carotid artery. Conclusion: This case highlights the importance of considering congenital vascular anomalies in young stroke patients and underscores the role of advanced neuroimaging in diagnosis.