Infarction Distribution Pattern in Acute Stroke May Predict the Extent of Leptomeningeal Collaterals

PloS One
Rajeev Kumar VermaKety Hsieh

Abstract

The aim of this study was to evaluate whether the distribution pattern of early ischemic changes in the initial MRI allows a practical method for estimating leptomeningeal collateralization in acute ischemic stroke (AIS). Seventy-four patients with AIS underwent MRI followed by conventional angiogram and mechanical thrombectomy. Diffusion restriction in Diffusion weighted imaging (DWI) and correlated T2-hyperintensity of the infarct were retrospectively analyzed and subdivided in accordance with Alberta Stroke Program Early CT score (ASPECTS). Patients were angiographically graded in collateralization groups according to the method of Higashida, and dichotomized in 2 groups: 29 subjects with collateralization grade 3 or 4 (well-collateralized group) and 45 subjects with grade 1 or 2 (poorly-collateralized group). Individual ASPECTS areas were compared among the groups. Means for overall DWI-ASPECTS were 6.34 vs. 4.51 (well vs. poorly collateralized groups respectively), and for T2-ASPECTS 9.34 vs 8.96. A significant difference between groups was found for DWI-ASPECTS (p<0.001), but not for T2-ASPECTS (p = 0.088). Regarding the individual areas, only insula, M1-M4 and M6 showed significantly fewer infarctions in the well-collate...Continue Reading

References

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Citations

May 26, 2016·Arquivos de neuro-psiquiatria·Heitor Castelo Branco Rodrigues AlvesAntonio J Rocha
Mar 25, 2019·European Radiology·Laurence LegrandUNKNOWN THRACE Investigators
Oct 13, 2020·Frontiers in Physiology·Olivia SobczykDavid J Mikulis

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