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Leukoaraiosis and Collaterals in Acute Ischemic Stroke
Author(s) -
Sanossian Nerses,
Ovbiagele Bruce,
Saver Jeffrey L.,
Alger Jeffry R.,
Starkman Sidney,
Kim Doojin,
Ohanian Arbi G.,
Buck Brian H.,
Ali Latisha K.,
Duckwiler Gary R.,
Jahan Reza,
Viñuela Fernando,
Liebeskind David S.
Publication year - 2011
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2010.00512.x
Subject(s) - medicine , neurology , stroke (engine) , gerontology , psychiatry , engineering , mechanical engineering
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.