Nitin Malik1, Qinghua Hou1, Achala Vagal2, James Patrie3, Wenjun Xin3, Patrik Michel4, Ashraf Eskandari4, Tudor Jovin5, Max Wintermark6. 1. Neuroradiology Division, Department of Radiology, University of Virginia, Charlottesville, Virginia. 2. Neuroradiology Division, Department of Radiology, University of Cincinnati, Cincinnati, Ohio. 3. Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia. 4. Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 5. Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania. 6. Neuroradiology Division, Department of Radiology, University of Virginia, Charlottesville, Virginia; Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: Max.Wintermark@gmail.com.
Abstract
BACKGROUND: Leptomeningeal collaterals improve outcome after stroke, including reduction of hemorrhagic complications after thrombolytic or endovascular therapy, smaller infarct size, and reduction in symptoms at follow-up evaluation. The purpose of this study was to determine the demographic and clinical variables that are associated with a greater degree of cerebral collaterals. METHODS: Clinical data of patients presenting with M1 occlusions of the middle cerebral artery (MCA) and associated computed tomography angiography studies after admission from 3 separate institutions were retrospectively compiled (n = 82). Occluded hemispheres were evaluated against the intact hemisphere for degree of collateralization in the MCA territory. Regression analysis of variance was conducted between clinical variables and collateral score to determine which variables associate with greater collateral development. RESULTS: Smaller infarct size corresponded to greater collateral scores, whereas older age and statin use corresponded to lower collateral scores (P < .001). CONCLUSIONS: Cerebral collateralization is influenced by age and statin use and influences infarct size.
BACKGROUND: Leptomeningeal collaterals improve outcome after stroke, including reduction of hemorrhagic complications after thrombolytic or endovascular therapy, smaller infarct size, and reduction in symptoms at follow-up evaluation. The purpose of this study was to determine the demographic and clinical variables that are associated with a greater degree of cerebral collaterals. METHODS: Clinical data of patients presenting with M1 occlusions of the middle cerebral artery (MCA) and associated computed tomography angiography studies after admission from 3 separate institutions were retrospectively compiled (n = 82). Occluded hemispheres were evaluated against the intact hemisphere for degree of collateralization in the MCA territory. Regression analysis of variance was conducted between clinical variables and collateral score to determine which variables associate with greater collateral development. RESULTS: Smaller infarct size corresponded to greater collateral scores, whereas older age and statin use corresponded to lower collateral scores (P < .001). CONCLUSIONS: Cerebral collateralization is influenced by age and statin use and influences infarct size.
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