Spontaneous Recanalization of Left Middle Cerebral Artery Occlusion Beyond the Thrombolysis Window

Large vessel occlusion (LVO)-induced acute ischemic stroke (AIS) manifests with abrupt onset and critical severity, primarily caused by cerebral artery atherosclerosis or cardiogenic embolism leading to luminal stenosis or occlusion. The authors report a case of acute massive cerebral infarction caused by occlusion of the left middle cerebral artery (MCA) and missed the time window for thrombolysis, in which spontaneous recanalization of the MCA was achieved after 1 week of conservative treatment. After 2 months of rehabilitation training, neurological functions and other symptoms significantly improved. This report aims to analyze the mechanisms and influencing factors of spontaneous recanalization in this patient's MCA, hoping to provide some support for the diagnosis and treatment of similar clinical cases.