Cerebral Collateral Circulation –  Potential Target for Cerebral Infarction Management

Authors: O. Volný 1–3;  R. Mikulík 1,3
Authors‘ workplace: Mezinárodní centrum klinického výzkumu (ICRC), Brno 1;  Anatomický ústav LF MU, Brno 2;  I. neurologická klinika LF MU a FN u sv. Anny v Brně 3
Published in: Cesk Slov Neurol N 2013; 76/109(3): 307-314
Category: Review Article


Leptomeningeal (pial) collaterals are native anastomoses that cross- connect the distal- most arterioles within the branches of the main cerebral arteries. They represent a potential emergency backdoor to maintain blood flow to the brain during an acute ischemic stroke. In addition, support of collateral circulation represents an attractive concept of stroke the­rapy. So far, neurologists mostly paid attention to recanalization therapies but neglected cerebral collateral circulation as a therapeutic target. This theme is very topical not only for cerebrovascular neurologists. The purpose of this article is to summarize information on a) anatomy and (patho)physiology of cerebral collateral circulation, b) diagnostics of colla­teral circulation including scoring systems using widely- available CT angiography, and c) pharmacological and non‑pharmacological therapies aimed at augmenting cerebral collateral circulation.

Key words:
stroke – collateral circulation – reperfusion – induced hypertension


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