Mangiafico et al reported a simple scale for reported collateral circulation following an acute ischemic stroke involving the anterior circulation. The status of the collateral circulation impacts the patient's outcome. The authors are from Careggi University Hospital in Florence, Italy.
Patient selection: acute ischemic stroke of the anterior circulation
Test: angiographic assessment of leptomeningeal collaterals in antero-posterior projection
CCS Grade
Retrograde Filling of Cortical ACA-MCA Territories
0
absent
1
in the territory of the ACA
2
visualization of collaterals until the suprainsular segment of the MCA
3
visualization of collaterals until the insular segment of the MCA
4
visualization of collaterals until the alar segment of the MCA
5
complete filling of contralateral hemisphere through the ACoA
ACA = anterior cerebral artery
MCA = middle cerebral artery
ACoA = anterior communicating artery
A favorable outcome (modified Rankin scale 0 to 2 at 3 months) is associated with CCS grades 2 to 5.
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