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Leukoaraiosis and collaterals in acute ischemic stroke
Nerses Sanossian1, Bruce Ovbiagele, Jeffrey L Saver
1Department of Neurology, University of Southern California, CA, USA. sanossia@yahoo.com
Summary
Leukoaraiosis, or white matter changes, does not correlate with collateral circulation in acute stroke patients. This suggests chronic small vessel disease is separate from the development of collateral blood flow.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Leukoaraiosis (white matter changes) is common in acute stroke.
- Its relationship with cerebral collateral circulation is not well understood.
- This study investigates if leukoaraiosis indicates chronic hypoperfusion or influences collateral development.
Purpose of the Study:
- To examine the correlation between angiographic collaterals in acute stroke and white matter changes (leukoaraiosis).
- To determine if leukoaraiosis is associated with chronic cerebral hypoperfusion or collateral circulation development.
Main Methods:
- 102 acute stroke patients with large-vessel occlusion underwent angiography.
- Pre-procedure CT or MRI assessed white matter changes using the Fazekas scale.
- Angiographic collaterals were graded and correlated with leukoaraiosis severity.
Main Results:
- No significant relationship was found between collateral grade and the presence or extent of periventricular white matter changes (P=.772).
- No significant relationship was found between collateral grade and deep white matter changes (P=.559).
- Leukoaraiosis severity did not correlate with collateral circulation in acute ischemic stroke.
Conclusions:
- Leukoaraiosis does not appear to be overtly related to collateral extent in acute ischemic stroke.
- Chronic small vessel disease may be a distinct pathophysiologic process.
- It may be unrelated to arteriogenesis and compensatory collateral flow mechanisms.
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