Spontaneous Recanalization of Internal Carotid Artery Occlusion: A Case Report.

IF 1.1 4区医学 Q4 CLINICAL NEUROLOGY Neurologist Pub Date : 2023-09-01 DOI:10.1097/NRL.0000000000000485

Sarah Y Zhang, Dylan Blacquiere, Brian Dewar, Grant Stotts, Dar Dowlatshahi

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Abstract

Introduction: 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.

Case report: 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.

Conclusions: 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.

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颈内动脉闭塞的自发再通术：一例报告。

引言：闭塞的颈内动脉（ICA）被认为不太可能自发再通。然而，越来越多的报告描述了这一现象。尽管如此，自发再通的频率、时间过程和机制仍然未知。在本文中，我们描述了一名有症状的左颈内动脉闭塞再通患者。病例报告：一名70岁的女性，因颈内动脉闭塞而出现短暂性言语停止和右上肢无力。3天后，她的虚弱和失语症再次出现，并短暂恶化。重复的计算机断层扫描血管造影术显示闭塞的ICA再通，以及先前灌注不足的左岛叶区域出现新的缺血性变化。这一发现将管理从医疗管理转变为支架血运重建，之后患者出院回家服用乙酰水杨酸和氯吡格雷。结论：尽管以前认为这种情况很少见，但自发性再通并不罕见。对这一现象的进一步研究，作为对这一问题的正确识别和定性，可以影响后续行动和管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurologist 医学-临床神经学

CiteScore

1.90

自引率

0.00%

发文量

151

审稿时长

2 months

期刊介绍： The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.