Late spontaneous recanalization of chronic middle cerebral artery occlusion

Abstract

Early spontaneous recanalization of the middle cerebral artery in acute ischemic phase artery is not uncommon, whereas the late spontaneous recanalization of chronic occluded artery is a very rare phenomenon and exact incidence and the timing of this event have not been quantified. We present a case in which late spontaneous recanalization of long-lasting middle cerebral artery occlusion occurred in the absence of surgical, endovascular and thrombolytic treatments.

Keywords: Angiography; Artheriosclerosis; Cerebrovascular disease.

Fig. 1

A. An Initial right carotid angiogram shows the occlusion of the proximal trunk of right middle cerebral artery (MCA) (arrow). The pial collaterals from anterior cerebral artery and the shift of the watershed zone are noted. B. Three-dimensional rotation angiography clearly reveals a tapered occlusion of proximal segment of M1 (arrow). Distal segment from occlusion and lenticulostriate arteries are filled by contrast media through basal collaterals. C. Diamox SPECT shows mild decrease of the reserve capacity at right MCA territory. D. CT angiography that is performed two months later shows persistent occlusion of right MCA (arrow). E. Twenty months later, right carotid angiography shows the recanalization of previously occluded segment of right MCA.