[Recanalisation after occlusion of the internal carotid artery]

In patients who have suffered a transient ischemic attack (TIA) or ischaemic stroke, diagnostic imaging often reveals an occlusion in the extracranial internal carotid artery (ICA) on the symptomatic side. It is generally assumed that no follow-up is needed.

A 57-year-old man reported to the emergency department with global aphasia. Two weeks previously he had been diagnosed with an occlusion of the left ICA following a TIA. On the basis of CT angiography we diagnosed an ischaemic stroke in the left middle cerebral artery territory and a severe stenosis of the left ICA. Several days later the patient underwent a successful carotid endarterectomy.

Following an acute symptomatic occlusion of the extracranial ICA, recanalisation of the artery can take place. In these patients we advise considering a repeat of the diagnostic imaging of the ICA within a week.