Aims and objectives
The presence of a favorable leptomeningeal collateral circulation (CC) is a strong predictor of neuroimaging outcomes and early and long-term clinical evolution after acute ischemic stroke.
Leptomeningeal circulation refers to a network of small vessels that interconnect the distal arteries of the brain.
In a sense,
they act as bridges that partially connect the different distal circulation systems of the brain (i.e.
median cerebral artery (MCA) with the anterior and posterior cerebral artery territories).
When there is an occlusion of the main arteries of the...
Methods and materials
One hundred and thirty-six consecutive patients with an acute ischemic stroke of less than 8h from symptoms onset were enrolled between February 2015 and May 2016.
All patients underwent non-contrast CT (NCCT),
CT perfusion (CTP),
and multiphase CT angiography (mCTA) on admission.
Only individuals with occlusion of the intracranial internal carotid artery (TICA) or M1 segment of the middle cerebral artery (MCA) proven by CTA and treated with endovascular thrombectomy were evaluated.
After excluding those without evaluable mCTA or CTP,
90 patients were...
Between February 2015 and May 2016,
136 patients with an anterior acute ischemic stroke with less than 8 hours from symptoms onset were evaluated. Patients with an occlusion of the intracranial internal carotid artery (TICA) or M1 segment of the middle cerebral artery (MCA) by CTA treated with endovascular reperfusion treatment were evaluated.
After excluding those patients without evaluable mCTA and/or CTP,
90 patients were finally included in the study.
Baseline clinical characteristics of the series are described on Table 1.
Mean age was 72.8±12.4...
Evaluation of CC has emerged in the last years as a relevant indicator of outcome in acute stroke patients.
This study shows the feasibility of a quick and easy method to evaluate CC on CTP: a single cortical ROI freehand-drawn on the semi-automated CTP maps generated during the acute stroke evaluation.
The absolute cCBV-ROI is immediately provided,
and if higher than 2.83 ml/cc,
the patient probably presents good CC,
and a high probability of a low infarct volume after 24 hours.
CTA or mCTA...
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