A 45-year-old woman who was diagnosed with mild hypertension during a medical checkup last year and was prescribed antihypertensive medication (amlodipine 2.5 mg/day), a calcium channel blocker, by her local physician. Her medical and family history were unremarkable, with no reported head injuries. She has no history of alcohol consumption or smoking. Since approximately the age of 35, she has experienced discomfort associated with visual auras without accompanying headaches, occurring every two to three months. She was evaluated by a local ophthalmologist, who found no abnormalities, including during a fundus examination. After the visual aura, she did not experience headaches or sensory, speech, or motor auras. The most recent aura occurred at the end of March 2023. On May 26, after dinner, she experienced an aura that recurred three times upon waking, without an apparent trigger. She reported an aura after breakfast and three more between evening and bedtime the next day. On May 28, she had one aura after breakfast and two around 4:00 p.m. All auras were consistent with her previous experiences.
Her vital signs were stable, with a blood pressure of 134/78 mmHg, pulse of 73/min, and temperature of 36.4°C. Her weight remained unchanged over the past year. Neurological examination revealed clear consciousness, no muscle weakness, normal deep tendon reflexes, no cranial nerve abnormalities, and no signs of pyramidal or cerebellar dysfunction. Additionally, there were no complaints of numbness, and her mental status and fundus examination were normal. Blood tests indicated normal liver and kidney function, blood glucose levels, and no signs of inflammation or anemia. 
The patient experienced mild claustrophobia and had difficulty undergoing prolonged magnetic resonance imaging (MRI). As a result, only diffusion-weighted imaging (DWI), fluid-attenuated inversion recovery (FLAIR) sequences, and magnetic resonance angiography (MRA) were conducted. The DWI and FLAIR sequences showed no abnormalities in the brain parenchyma (DWI not shown). However, the MRA images were compromised by motion artifacts. Consequently, computed tomographic angiography was performed, revealing no significant stenosis of the main arteries. Nonetheless, slight stenosis was noted in the left M1 and right M2 segments of the middle cerebral artery (MCA), likely representing flexure or mild sclerotic changes. The electroencephalography findings were normal.