Evidence map›Paper›PMID 42507506›Full record

ArticleAnnals of Indian Academy of Neurology2026

Factors Associated with Leptomeningeal Collaterals and Their Impact on Functional Outcomes in Anterior Circulation Acute Ischemic Stroke.

Sharath Chandra Shetty, Naveen Kumar Paramasivan, Arun Prasad Balasubramanian, Harikrishnan Ramachandran, Chandrasekharan Kesavadas, Sapna E Sreedharan, V T Jissa, P N Sylaja

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Article in Annals of Indian Academy of Neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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8 authors.

Sharath Chandra ShettyDepartment of Neurology, Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Naveen Kumar ParamasivanDepartment of Neurology, Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Arun Prasad BalasubramanianDepartment of Imaging Science and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Harikrishnan RamachandranDepartment of Neurology, Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Chandrasekharan KesavadasDepartment of Imaging Science and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Sapna E SreedharanDepartment of Neurology, Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
V T JissaDepartment of Biostatistics, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
P N SylajaDepartment of Neurology, Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesLeptomeningeal collaterals are essential for maintaining cerebral perfusion during acute large vessel occlusion (LVO) and are predictive of favorable outcomes in stroke patients. However, the factors influencing baseline collateral status are not well understood. We aimed to identify factors predicting poor baseline collateral status and unfavorable 3-month outcomes in acute ischemic stroke (AIS) patients with LVO in the anterior circulation in the Indian subcontinent.

methodsWe retrospectively enrolled 239 patients who underwent computed tomography angiography within 24 hours of acute ischemic stroke. Patient demographics, vascular risk factors, baseline stroke severity, etiology, and 3-month functional outcomes were collected.

resultsThe mean age was 59.5 ± 13.5 years; 152 (64%) patients were males, and the median baseline National Institutes of Health Stroke Scale (NIHSS) score was 15. Bivariate analysis showed that male sex (77% vs. 58%, P = 0.004), absence of valvular disease (92% vs. 82%), lower clot burden score (CBS) (32% vs. 16%, P = 0.003), and renal dysfunction (11% vs. 3%, P = 0.01) were associated with poor collateral status. Logistic regression identified renal dysfunction (odds ratio [OR] 3.9; 95% confidence interval [CI], 1.2-14.68; P = 0.031) and lower CBS (OR, 0.40; 95% CI, 0.23-0.93; P = 0.030) as independently associated with poor collateral status. Poor 3-month outcomes were associated with older age (OR, 1.96; 95% CI, 1.05-3.68; P = 0.034), large vessel atherosclerosis (OR, 2.66; 95% CI, 1.27-5.56; P = 0.009), and poor collateral status (OR, 2.35; 95% CI, 1.18-4.66; P = 0.014).

conclusionsLower CBS and renal dysfunction were associated with poor collateral status at baseline in AIS patients with LVO. Advanced age, large vessel atherosclerosis, poor collateral status, and greater stroke severity predicted poor functional outcomes at 3 months.

Indexed as

acute ischemic strokebaseline collateral statusfunctional outcomeLeptomeningeal collateral circulationneuroimagingpredictors

Identifiers

PMID42507506
PMCPMC13544895

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