• Nerses Sanossian, Bruce Ovbiagele, Jeffrey L Saver, Jeffry R Alger, Sidney Starkman, Doojin Kim, Arbi G Ohanian, Brian H Buck, Latisha K Ali, Gary R Duckwiler, Reza Jahan, Fernando Viñuela, and David S Liebeskind.
• Department of Neurology, University of Southern California, CA, USA. sanossia@yahoo.com
• J Neuroimaging. 2011 Jul 1; 21 (3): 232235232-5.

BackgroundWe 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.MethodsConsecutive 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.ResultsCollaterals 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).ConclusionsLeukoaraisosis 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.© 2010 by the American Society of Neuroimaging.

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