Background: Capsular warning syndrome (CWS) is defined as a recurrent stereotype transient lacunar syndrome without cortical symptoms. However, to date, there is limited literature proposed on the definitive treatment options for the prevention of persistent stroke in cases of capsular warning syndrome. Aim: The aim of this case report is to address dual antiplatelet therapy as a treatment choice in CWS to prevent progressive stroke. Case presentation: A 56-year-old man with several comorbidities experienced recurrent periods of limb weakness and dysarthria lasting 5 - 20 minutes with a complete resolution of symptoms in between. The fluctuating episodes lasted for 72 hours followed by a persistent minor stroke. A gadolinium-enhanced MRI scan of the brain revealed a right basal ganglia infarct. He was treated with dual antiplatelet, and his functional outcome was favourable at 90 days post stroke. Conclusion: Dual antiplatelet may be a beneficial therapeutic option in CWS in improving functional outcomes in the early neurological deficit and decreasing the clinical fluctuation.
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