Spontaneous reperfusion of cerebral infarcts in patients with acute stroke. Incidence, time course, and clinical outcome in the Copenhagen Stroke Study

Arch Neurol. 1994 Sep;51(9):865-73. doi: 10.1001/archneur.1994.00540210037011.


Objective: To determine the incidence, time course, and clinical importance of spontaneous reperfusion of cerebral infarcts in patients with acute stroke.

Design: Prospective, community based.

Setting: Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark.

Patients: Included in the incidence and time course study were 354 unselected patients with acute ischemic stroke. Clinical outcome was studied in a subgroup of 36 patients admitted on the day of stroke onset and in whom it was known whether spontaneous reperfusion occurred within the first week after stroke onset.

Measurements: Computed tomography and single photon emission computed tomography, with technetium Tc 99m exametazime used as a flow tracer. The Scandinavian Stroke Scale neurologic score was determined on admission, 1 and 2 weeks after stroke, and at discharge.

Results: The incidence of spontaneous reperfusion was 77% in patients with cortical infarcts. The frequency of reperfusion increased rapidly from zero at the time of onset to 60% on day 7 after stroke, reaching a maximum on day 14, at which time 77% showed reperfusion. Marked clinical improvement was observed in patients with spontaneous reperfusion (P = .001), while no improvement occurred in patients without reperfusion. Reperfusion was not observed in subcortical infarcts.

Conclusions: The rate of spontaneous reperfusion increases gradually with time and occurs within the first 2 weeks after stroke onset in approximately four of five patients with cortical infarcts. Spontaneous reperfusion seemed to improve clinical outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain / blood supply
  • Cerebral Infarction / complications
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / physiopathology*
  • Cerebrovascular Circulation*
  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / etiology
  • Cerebrovascular Disorders / physiopathology*
  • Female
  • Humans
  • Male
  • Remission, Spontaneous
  • Tomography, Emission-Computed