Document Detail

Assessment of leptomeningeal collaterals using dynamic CT angiography in patients with acute ischemic stroke.
MedLine Citation:
PMID:  23149554     Owner:  NLM     Status:  MEDLINE    
Whole-brain dynamic time-resolved computed tomography angiography (CTA) is a technique developed on the new 320-detector row CT scanner capable of generating time-resolved cerebral angiograms from skull base to vertex. Unlike a conventional cerebral angiogram, this technique visualizes pial arterial filling in all vascular territories, thereby providing additional hemodynamic information. Ours was a retrospective study of consecutive patients with ischemic stroke and M1 middle cerebral artery +/- intracranial internal carotid artery occlusions presenting to our center from June 2010 and undergoing dynamic time-resolved CTA and perfusion CT within 6 hours of symptom onset. Leptomeningeal collateral status was assessed by determining relative prominence of pial arteries in the ischemic region, rate and extent of retrograde flow, and various topographical patterns of pial arterial filling. Twenty-five patients were included in the study. We demonstrate the existence of the following novel properties of leptomeningeal collaterals in humans: (a) posterior (posterior cerebral artery (PCA)-MCA) dominant collateralization, (b) intra-territorial 'within MCA region' leptomeningeal collaterals, and (c) significant variability in size, extent, and retrograde filling time in pial arteries. We also describe a simple and reliable collateral grading template that, for the first time on dynamic CTA, incorporates back-filling time as well as size and extent of collateral filling.
Bijoy K Menon; Billy O'Brien; Andrew Bivard; Neil J Spratt; Andrew M Demchuk; Ferdinand Miteff; Xuewen Lu; Christopher Levi; Mark W Parsons
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2012-11-14
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  33     ISSN:  1559-7016     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-01     Completed Date:  2013-04-19     Revised Date:  2014-03-07    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  365-71     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Cerebral Angiography / methods*
Infarction, Middle Cerebral Artery / radiography*
Middle Aged
Perfusion Imaging / methods
Posterior Cerebral Artery / radiography*
Retrospective Studies
Stroke / radiography*
Tomography, X-Ray Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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