[Relation between neurologic damage and collateral circulation detected by Doppler CW in occlusive pathology of the internal carotid]
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Collateral circulation via the ophthalmic artery or Willis circle in acute ischemic encephalopathy does not predict disability. However, these collateral pathways influence stroke and reversible ischemic attack (RIA) pathology.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Context:
- Acute ischemic encephalopathy resulting from internal carotid artery (ICA) occlusion presents a significant clinical challenge.
- Assessing the impact of collateral circulation on neurological outcomes is crucial for patient management.
Purpose:
- To investigate the influence of different collateral circulation pathways on neurological damage in patients with acute ischemic encephalopathy due to ICA occlusion.
- To evaluate the prognostic value of ophthalmic artery versus Willis circle collateral compensation for patient disability.
Summary:
- Doppler sonography was used to examine 76 patients with acute ischemic encephalopathy from ICA occlusion.
- Collateral circulation through the ophthalmic artery (80% of cases) and Willis circle (70% of cases) were analyzed.
- While both collateral types showed no significant prognostic value for disability, a notable difference in pathology distribution was observed: ophthalmic artery compensation was associated with 40% stroke and 60% reversible ischemic attack (RIA), whereas Willis circle compensation was linked to 77% stroke and 23% RIA.
Impact:
- Findings suggest that the type of collateral circulation, specifically ophthalmic artery versus Willis circle, significantly impacts the likelihood of stroke versus reversible ischemic attack (RIA).
- This study highlights the importance of characterizing collateral pathways in acute ischemic stroke for understanding disease patterns and potentially tailoring treatment strategies.
Abstract:
76 patients affected by acute ischemic encephalopathy due to i.c.a. occlusion have been examined through a Doppler nosography, in order to evaluate the influence of the type of collateral circle on the neurologic damage. Collateral circles between the external and internal carotid arteries were established through the ophthalmic artery in 80% of cases (A) and through the Willis circle in 70% of cases (B). Those two types of compensation do not seem to have prognostic value with regard to disability; on the contrary a remarkable difference was observed in the type of pathology (A = Stroke 40%, RIA 60%; B = 77%, RIA 23%).