Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec.
Department of Medicine (Neurology), University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Neurologist. 2023 Sep 1;28(5):324-325. doi: 10.1097/NRL.0000000000000485.
Spontaneous recanalization of an occluded internal carotid artery (ICA) is thought to be unlikely. However, there has been a growing number of reports describing this phenomenon. Despite this, the frequency, time course, and mechanism of spontaneous recanalization remain unknown. In this paper, we describe a patient with a symptomatic recanalization of an occluded left ICA.
A 70-year-old woman presented with transient speech arrest and right upper extremity weakness related to an occluded ICA. After 3 days, her weakness and aphasia reappeared and worsened transiently. A repeat computed tomography angiography revealed recanalization of the occluded ICA, as well as new ischemic changes in the previously hypoperfused left insular region. This finding changed the management from medical management to revascularization with a stent, after which the patient was discharged home with acetylsalicylic acid and clopidogrel.
Although previously thought to be a rare occurrence, spontaneous recanalization is not uncommon. Further research into this phenomenon as proper identification and characterization of this phenomenon can influence follow-up and management.
阻塞的颈内动脉（ICA）自发再通被认为不太可能。然而，越来越多的报告描述了这种现象。尽管如此，自发再通的频率、时间进程和机制仍不清楚。在本文中，我们描述了一例症状性阻塞左侧 ICA 再通的患者。
一名 70 岁女性因阻塞的 ICA 出现短暂性言语中止和右侧上肢无力。3 天后，她的无力和失语症再次出现并短暂恶化。重复的计算机断层血管造影显示阻塞的 ICA 再通，以及先前灌注不足的左侧岛叶区域出现新的缺血性改变。这一发现将治疗方案从药物治疗改为支架血管重建，之后患者出院，服用阿司匹林和氯吡格雷。
尽管先前认为这是一种罕见的情况，但自发性再通并不罕见。进一步研究这一现象，并正确识别和描述这一现象，可以影响后续治疗和管理。
