Spontaneous Arterial Recanalization in the Acute Stage of Cerebral Infarction

Abstract

Thirty-nine patients with cerebral infarction were included in a comparative study of the effects of spontaneous arterial recanalization. In all cases, arterial occlusion was confirmed by angiography performed on admission. In 16 cases, spontaneous recanalization of the occluded arteries was disclosed by follow-up angiography. In the remaining 23 cases, follow-up angiography did not demonstrate recanalization. The features of recanalization can be summarized as follows: 1) the branches and secondary trunk of the middle cerebral artery were most often involved; 2) the cause of the occlusion was usually embolic and the onset of symptoms generally sudden; 3) approximately 50% of the patients died or had severe deficits; and 4) sequential measurement of cerebral blood flow revealed a temporary increase in the subacute stage, which was probably due to arterial recanalization. The features of nonrecanalization were: 1) the cervical internal carotid arteries and main trunk of the middle cerebral artery were most often occluded; 2) the cause of occlusion was mainly thrombotic and the stroke was usually of the progressive type; 3) the outcome was comparatively good, with 80% of the patients able to resume their previous lives; and 4) sequential measurement of cerebral blood flow showed lower flow in the affected than in the nonaffected hemisphere, with little change over time.