[Long lasting intracranial artery stenosis of embolic origin]

The term evanescent, or vanishing, has been used to describe those intracranial stenoses that are consecutive to the partial recanalization of an embolic occlusion. In general terms it has been admitted that those stenoses quickly disappear in parallel to the complete recanalization of the artery. This behaviour allows their differentiation from the atherosclerotic stenoses.

We present here a 61-year-old male who suffered a middle cerebral artery territory stroke secondary to an atrial fibrillation. In the acute phase, a stenotic flow was found in the proximal portion of his left middle cerebral artery. Although it was an embolic occlusion, one year passed before the stenosis disappeared.

Findings like this contradict the protocols in use (which consider a stenosis as atherosclerotic if it remains for more than three months), and stress the need for new studies which clarify the natural history of the intracranial arterial occlusions.