Spontaneous Middle Cerebral Artery Reperfusion in Ischemic Stroke

Abstract

Background and Purpose The aim of this study was to investigate by means of transcranial Doppler (TCD) ultrasonography how many spontaneous reperfusions of the middle cerebral artery (MCA) occurred during the first week after onset of acute ischemic stroke in the carotid territory. Methods TCD examination, computed tomographic scan, and arterial digital angiography were performed in 56 patients with acute ischemic stroke within 6 hours of the onset of symptoms. The TCD examination was repeated within 24 hours, 48 hours, and 7 days after stroke; a further TCD examination was performed within 3 to 9 months in 27 patients. Results At 6 hours, 33 patients presented abnormal TCD findings in the symptomatic MCA (16 “no flows” and 17 asymmetries). Of these, 4 patients (3 no flows and 1 asymmetry) died before the 7-day follow-up was completed, whereas of the 29 remaining patients undergoing all the TCD control examinations, only 14 presented permanently abnormal TCD findings (7 asymmetries and 7 no flows). These ...