Leukoaraiosis and collaterals in acute ischemic stroke.

Autor: Sanossian N; Department of Neurology, University of Southern California, CA, USA. sanossia@yahoo.com, Ovbiagele B, Saver JL, Alger JR, Starkman S, Kim D, Ohanian AG, Buck BH, Ali LK, Duckwiler GR, Jahan R, Viñuela F, Liebeskind DS
Jazyk: angličtina
Zdroj: Journal of neuroimaging : official journal of the American Society of Neuroimaging [J Neuroimaging] 2011 Jul; Vol. 21 (3), pp. 232-5. Date of Electronic Publication: 2010 Oct 26.
DOI: 10.1111/j.1552-6569.2010.00512.x
Abstrakt: 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.
(© 2010 by the American Society of Neuroimaging.)
Databáze: MEDLINE
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