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Related Experiment Video

Updated: Aug 23, 2025

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Collateral status, hyperglycemia, and functional outcome after acute ischemic stroke.

Daniel F Arteaga1, Robin Ulep2, Kevin K Kumar3

  • 1Department Neurology, St Thomas Rutherford Hospital, Murfreesboro, 1700 Medical Center Pkwy, Murfreesboro, TN, 37129, USA. darteaga08@gmail.com.

BMC Neurology
|November 5, 2022
PubMed
Summary

Collateral status did not alter the link between glucose control and stroke outcomes in large vessel occlusion. However, good collateral flow was linked to better functional outcomes after stroke.

Keywords:
AngiographyDiabetesHyperglycemiaIntracranial collateralsIschemic strokeOutcome

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Area of Science:

  • Neurology
  • Stroke Research
  • Medical Imaging

Background:

  • Hyperglycemia's effect on stroke outcomes is debated, especially with collateral flow.
  • Leptomeningeal collateral status may influence stroke recovery.
  • The Stroke Hyperglycemia Insulin Network Effort (SHINE) trial investigated glucose control in stroke patients.

Purpose of the Study:

  • To examine if collateral status modifies the association between glucose control treatment and functional outcome.
  • To analyze a subset of patients with large vessel occlusion from the SHINE trial.

Main Methods:

  • Post-hoc analysis of 57 patients with anterior circulation large vessel occlusion from the SHINE trial.
  • CT angiography used to assess collateral status prior to treatment.
  • Logistic regression analyzed functional outcome (90-day modified Rankin Scale) adjusted for key clinical factors.

Main Results:

  • Collateral status did not significantly modify the association between glucose control treatment and functional outcome (p=0.855).
  • Patients with good collaterals showed a significantly higher likelihood of favorable functional outcomes (p=0.001, OR 5.02).

Conclusions:

  • Collateral status does not appear to modify the impact of glucose control interventions on functional outcomes in large vessel occlusion stroke.
  • Good collateral flow remains a significant predictor of favorable outcomes in these patients.