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We studied three patients with internal carotid artery occlusion at the siphon who had recanalization during 1 month of close observation. Angiography and duplex carotid sonography (DCS) were repeated serially in each patient. Blood flow patterns detected by DCS were classified into three patterns by specific angiographic changes. The distal occlusive flow pattern on DCS corresponds to internal carotid artery occlusion at the siphon angiographically, the median flow pattern on DCS corresponds to partial recanalization, and a normal flow pattern on DCS indicates almost complete recanalization. Since DCS can be easily repeated, the exact time of recanalization can be determined noninvasively. In all three patients, hemorrhagic infarction observed on computed tomograms occurred at the time of recanalization detected by DCS. DCS demonstrates that recanalization is one of the mechanisms of hemorrhagic infarction.

Recanalization of intracranial carotid occlusion detected by duplex carotid sonography.