Effects of spontaneous recanalization on functional and electrophysiological recovery in acute ischemic stroke

Background and Purpose-Transcranial Doppler ultrasound (TCD) studies have s hown that spontaneous recanalization results in a better clinical improveme nt after the onset of stroke. However, its effect on electrophysiological r ecovery is still unknown. The aim of this study was to determine the effect s of spontaneous recanalization on the change in central motor conduction t ime (CMCT) in acute ischemic stroke. Methods-Seventeen healthy subjects and 38 consecutive patients with a first acute ischemic stroke involving the middle cerebral artery territory were included. TCD was used to detect spontaneous recanalization. Transcranial m agnetic stimulation was used to determine the change in CMCT on days 1 and 14. Improvement of the CMCT at day 14 was indicated if it decreased in comp arison with previous data recorded at day 1 or when a nonrecordable motor r esponse at day 1 reappeared at day 14. No CMCT improvement was indicated wh en there was no recordable motor response at day 1 and day 14 or the CMCT a t day 14 worsened, becoming absent or more delayed. The Pearson chi(2) test was used to assess the statistical significance of the results in this stu dy. Results-Spontaneous recanalization was observed in 62% of the patients: 24% before 24 hours and 38% after this period. No recanalization was observed in 14 patients. The CMCT improved in 87% of the patients who had recanalize d before 24 hours and 62% in the recanalized after 24 hours group (P = 0.00 5). In contrast, CMCT improved in only 17% of the patients in the non-recan alized group Conclusions-These data show that spontaneous recanalization results in a be tter recovery of the central motor pathway leading to a better CMCT improve ment in acute ischemic stroke.