Predictive factors for brain collateral circulation analysis in ischemic stroke

Abstract

Introduction: Cerebral collateral circulation has become increasingly important in recent years. It is a physiological vascular protection circuit, designed to preserve cerebral irrigation in a failure context of the primary pathways. Methods: This retrospective, descriptive and analytical study aims to analyze the predictive factors for the collateral circulation presence in patients with acute ischemic stroke, seen in the emergency room of the Santa Casa de Misericórdia Hospital in São Paulo, with large vessels occlusion on angiotomography. Results: 21 patients were analysed between january 2018 and april 2020, 10 men and 11 women, with a median age of 71 years. The median NIHSS score was 16 and intravenous thrombolysis was performed in 71.4% of the patients. We identified the presence of hyperglycemia, cervical obstruction and female gender as factors independently associated with an unsatisfactory leptomeningeal collateral state. Systemic arterial hypertension, smoking, alcoholism and a history of stroke had no association with poor collateral status, as well as the previous use of sinvastatin does not improve the combined score. Conclusion: Knowing the risk factors and comorbidities associated with the rarefaction of cerebral collateral circulation is of great importance in assessing the ischemic stroke acute phase, contributing to improvement in treatment and primary and secondary prevention.