• Ying Mao, Yujing Huang, Li Zhang, and Guangxian Nan.
• Department of Neurology, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, Jilin, China.
• Medicine (Baltimore). 2017 Jul 1; 96 (27): e7372.

RationaleIntracranial vascular atherosclerotic occlusion is one of the most common causes of ischemic stroke world wide. The involvement of large intracranial vessels, in particular, the middle cerebral artery, is usually associated with unfavorable outcomes in patients. Spontaneous recanalization of atherosclerotic occlusion is relatively rare.Patient ConcernsThe first patient was a 43-year-old male with slurred speech and left-sided weakness for a duration of 24 hours. The second was a 59-year-old male with left-sided weakness over a period of 13 hours. The last was a 49-year-old female patient presented with a 1-month history of right-sided headache.DiagnosesAtherosclerotic middle cerebral artery occlusion.InterventionsIn all cases, oral aspirin (100 mg; once daily), Plavix (75 mg; once daily), and Lipitor (40 mg; once daily) were used . Oral Plavix was stopped 3 months.OutcomesSpontaneous recanalization occured in the three cases of atherosclerotic middle cerebral artery occlusion.LessonsSpontaneous recanalization may occur in both early and late stages of atherosclerotic middle cerebral artery occlusion. Clinicians should be aware of this particular condition, as it may represent a relatively favorable prognosis.

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