Document Detail


Leukoaraiosis and collaterals in acute ischemic stroke.
MedLine Citation:
PMID:  20977524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined the correlation of angiographic collaterals in acute stroke with the presence, extent, and distribution of white matter changes, so-called Leukoaraiosis, in an effort to determine if Leukoaraiosis indicates chronic cerebral hypoperfusion and/or is associated with the development of cerebral collateral circulation.
METHODS: Consecutive acute strokes due to large-vessel occlusion on angiography had preprocedure CT or MRI white matter changes graded utilizing the Fazekas scale incorporating deep and periventricular components. Angiographic collaterals evaluated with a 5-point scale were correlated with leukoaraiosis.
RESULTS: Collaterals were evaluated in 102 cases (51 men, 51 women; mean age 66 (SD 18) years with acute occlusions of the proximal middle cerebral artery (MCA) (47%), distal internal carotid artery (ICA) (28%), distal MCA (9%), basilar (7%), proximal ICA (7%), vertebral (1%), posterior cerebral artery (PCA) (1%), and common carotid artery (CCA) (1%). Collateral grade was well distributed across the scale. Periventricular and deep white matter changes were evident in 34% and 51% of cases, respectively. Collateral grade exhibited no relationship with either the presence or extent of periventricular disease (P= .772, r= .029) or deep white matter changes (P= .559, r=-.059).
CONCLUSIONS: Leukoaraisosis exhibits no overt relationship with the extent of collaterals measured at angiography in acute ischemic stroke. Chronic small-vessel disease may be a distinct pathophysiologic entity unrelated to arteriogenesis and compensatory aspects of collateral flow.
Authors:
Nerses Sanossian; Bruce Ovbiagele; Jeffrey L Saver; Jeffry R Alger; Sidney Starkman; Doojin Kim; Arbi G Ohanian; Brian H Buck; Latisha K Ali; Gary R Duckwiler; Reza Jahan; Fernando Viñuela; David S Liebeskind
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-26
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  21     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-28     Completed Date:  2011-10-28     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  232-5     Citation Subset:  IM    
Copyright Information:
© 2010 by the American Society of Neuroimaging.
Affiliation:
Department of Neurology, University of Southern California, CA, USA. sanossia@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brain / blood supply,  pathology,  radiography*
Brain Ischemia / pathology,  radiography*
Cerebral Angiography
Cerebrovascular Circulation
Collateral Circulation*
Female
Humans
Leukoaraiosis / pathology,  radiography*
Male
Middle Aged
Retrospective Studies
Stroke / pathology,  radiography*
Grant Support
ID/Acronym/Agency:
K23 NS054084-01A1/NS/NINDS NIH HHS; K23NS054084/NS/NINDS NIH HHS
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