We 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.
Consecutive acute strokes due to large vessel occlusion on angiography had pre-procedure 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.
Collaterals were evaluated in 102 cases (51 men, 51 women; mean age 66 (SD 18) years with acute occlusions of the proximal MCA (47%), distal ICA (28%), distal MCA (9%), basilar (7%), proximal ICA (7%), vertebral (1%), PCA (1%), and 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).
Leukoaraisosis 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.