title: Semi-quantitative and qualitative evaluation of pial leptomeningeal collateral circulation in acute ischemic stroke of the anterior circulation: the Careggi Collateral Score.
abstract: BACKGROUND
  The imaging of ischemic penumbra in acute stroke is a debated issue and establishing commonly accepted criteria is difficult. Computerized tomography-perfusion studies conducted in animals have showed that the modifications occurring in the brain parenchima are part of a dynamic and progressive process involving the microcirculation. The purpose of this paper is to propose a new angiographic classification of collateral circulation in patients with acute ischemic stroke, with a possible correlation with the clinical outcome.
  
  
  METHODS
  The basal angiograms of 57 patients with acute ischemic stroke is the territory of anterior circulation secondary to a major occlusion, who underwent endovascular treatment, were retrospectively reviewed and collaterals were classified according to our novel Careggi Collateral Score in 6 grades (0-6). The clinical outcome after 3 months was evaluated with modified Rankin Scale. A ROC (receiver operating characteristic) curve analysis identified a cut-off value of 1.
  
  
  RESULTS
  Patients with favorable collateral circulation (grades 2-5) showed a significant correlation with good clinical outcome (modified Rankin Scale < or = 2).
  
  
  CONCLUSIONS
  The Careggi Collateral Score resulted a useful tool to evaluate the chance of obtaining a favorable result with endovascular treatment in patients with acute ischemic stroke in the anterior circulation secondary to the occlusion of a major artery.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mangiafico
authors.forename: Arturo
authors.initials: A
authors.lastname: Consoli
authors.forename: Leonardo
authors.initials: L
authors.lastname: Renieri
authors.forename: Andrea
authors.initials: A
authors.lastname: Rosi
authors.forename: Alioscia
authors.initials: A
authors.lastname: De Renzis
authors.forename: Chiara
authors.initials: C
authors.lastname: Vignoli
authors.forename: Leonardo
authors.initials: L
authors.lastname: Capaccioli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D003097:Collateral Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008578:Meninges / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010841:Pia Mater / Q000098:blood supply* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology*