Wide Genetic Variation in the Native Pial Collateral Circulation is a Major Determinant of Variation in Severity of Stroke

Zhang, Hua; Prabhakar, Pranay; Sealock, Robert; Faber, James E.

doi:10.1038/jcbfm.2010.10

Cited by 225 publications

(434 citation statements)

References 38 publications

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“…Overall, 37.6% had good (17)(18)(19)(20), 40.5% had medium (11)(12)(13)(14)(15)(16), and 21.7% had poor (0 -10) rLMC scores. Median stroke onset to CTA time was 164 minutes; most patients (75%) were scanned at 361 or fewer minutes after stroke onset.…”

Section: Resultsmentioning

confidence: 99%

“…Higher rLMC score was significantly correlated with lower baseline NIHSS (Spearman r ϭ Ϫ0.36; 95% CI, Ϫ0.50% to Ϫ0.21%; P Ͻ .001) and with lower mRS at 3 months (Spearman r ϭ Ϫ0.47; 95% CI, Ϫ0.59% to Ϫ0.33%; P Ͻ .001). Good clinical outcome was seen in 52% of patients with good rLMC score (17)(18)(19)(20), 34% with medium rLMC score (11)(12)(13)(14)(15)(16), and 7% with poor rLMC score (0 -10) (P Ͻ .001). In univariate analysis, higher rLMC score, lower age, lower baseline NIHSS, higher baseline ASPECTS and CTAsi ASPECTS, higher clot burden score, and any endovascular therapy (IA alone or IV ϩ IA tPA or mechanical) were associated with good clinical outcome (On-line Table 1).…”

Section: Variables Associated With Good Clinical Outcome Mrs <2mentioning

confidence: 90%

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Regional Leptomeningeal Score on CT Angiography Predicts Clinical and Imaging Outcomes in Patients with Acute Anterior Circulation Occlusions

Menon¹,

Smith²,

Modi³

et al. 2011

AJNR Am J Neuroradiol

292

244

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Section: Resultsmentioning

confidence: 99%

Section: Variables Associated With Good Clinical Outcome Mrs <2mentioning

confidence: 90%

Regional Leptomeningeal Score on CT Angiography Predicts Clinical and Imaging Outcomes in Patients with Acute Anterior Circulation Occlusions

Menon¹,

Smith²,

Modi³

et al. 2011

AJNR Am J Neuroradiol

292

244

View full text Add to dashboard Cite

show abstract

“…5C). Long-term changes in the vasculature could compensate for this hypoperfusion and ameliorate potential damage at threshold levels of flow (42,43).…”

Section: Discussionmentioning

confidence: 99%

Topological basis for the robust distribution of blood to rodent neocortex

Blinder¹,

Shih²,

Rafie³

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

165

224

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The maintenance of robust blood flow to the brain is crucial to the health of brain tissue. We examined the pial network of the middle cerebral artery, which distributes blood from the cerebral arteries to the penetrating arterioles that source neocortical microvasculature, to characterize how vascular topology may support such robustness. For both mice and rats, two features dominate the topology. First, interconnected loops span the entire territory sourced by the middle cerebral artery. Although the loops comprise <10% of all branches, they maintain the overall connectivity of the network after multiple breaks. Second, >80% of offshoots from the loops are stubs that end in a single penetrating arteriole, as opposed to trees with multiple penetrating arterioles. We hypothesize that the loops and stubs protect blood flow to the parenchyma from an occlusion in a surface vessel. To test this, we assayed the viability of tissue that was sourced by an individual penetrating arteriole following occlusion of a proximal branch in the surface loop. We observed that neurons remained healthy, even when occlusion led to a reduction in the local blood flow. In contrast, direct blockage of a single penetrating arteriole invariably led to neuronal death and formation of a cyst. Our results show that the surface vasculature functions as a grid for the robust allocation of blood in the event of vascular dysfunction. The combined results of the present and prior studies imply that the pial network reallocates blood in response to changing metabolic needs.anastomoses | imaging | networks | stroke | vasculature

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“…Hence, the results of this group have to be compared with the other groups with care. It has been shown that infarct volumes and cerebrovascular anatomy vary with genetic background 11,12 and larger infarcts have been observed in the C57Bl/6 compared with the SV129 strain. 41 However, a study by Pham et al found no differences of infarct sizes, ADC, or CBF at any time point between SV129 and C57Bl/6 mice after transient MCAO.…”

Section: Weaknesses Of Our Studymentioning

confidence: 99%

“…Despite these advantages, variability of infarct sizes is substantial, owing to the variability of the surgical procedure 8,9 and interanimal variability of brain blood vessel anatomy [10][11][12] among other factors. Because of the substantial infarct size variability (SDs usually ≈30% of the mean) and small group sizes (between 4 and 10) in experimental stroke research, it is likely that false-positive results and an overestimation of effect sizes abound in publications.…”

Section: Strokementioning

confidence: 99%

Infarct Volume Prediction by Early Magnetic Resonance Imaging in a Murine Stroke Model Depends on Ischemia Duration and Time of Imaging

Leithner

Füchtemeier

Jorks

et al. 2015

Stroke

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Background and Purpose— Despite standardization of experimental stroke models, final infarct sizes after middle cerebral artery occlusion (MCAO) vary considerably. This introduces uncertainties in the evaluation of drug effects on stroke. Magnetic resonance imaging may detect variability of surgically induced ischemia before treatment and thus improve treatment effect evaluation. Methods— MCAO of 45 and 90 minutes induced brain infarcts in 83 mice. During, and 3 and 6 hours after MCAO, we performed multiparametric magnetic resonance imaging. We evaluated time courses of cerebral blood flow, apparent diffusion coefficient (ADC), T1, T2, accuracy of infarct prediction strategies, and impact on statistical evaluation of experimental stroke studies. Results— ADC decreased during MCAO but recovered completely on reperfusion after 45 and partially after 90-minute MCAO, followed by a secondary decline. ADC lesion volumes during MCAO or at 6 hours after MCAO largely determined final infarct volumes for 90 but not for 45 minutes MCAO. The majority of chance findings of final infarct volume differences in random group allocations of animals were associated with significant differences in early ADC lesion volumes for 90, but not for 45-minute MCAO. Conclusions— The prediction accuracy of early magnetic resonance imaging for infarct volumes depends on timing of magnetic resonance imaging and MCAO duration. Variability of the posterior communicating artery in C57Bl6 mice contributes to differences in prediction accuracy between short and long MCAO. Early ADC imaging may be used to reduce errors in the interpretation of post MCAO treatment effects on stroke volumes.

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Wide Genetic Variation in the Native Pial Collateral Circulation is a Major Determinant of Variation in Severity of Stroke

Cited by 225 publications

References 38 publications

Regional Leptomeningeal Score on CT Angiography Predicts Clinical and Imaging Outcomes in Patients with Acute Anterior Circulation Occlusions

Regional Leptomeningeal Score on CT Angiography Predicts Clinical and Imaging Outcomes in Patients with Acute Anterior Circulation Occlusions

Topological basis for the robust distribution of blood to rodent neocortex

Infarct Volume Prediction by Early Magnetic Resonance Imaging in a Murine Stroke Model Depends on Ischemia Duration and Time of Imaging

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