Modelling collateral flow and thrombus permeability during acute ischaemic stroke

The presence of collaterals and high thrombus permeability are associated with good functional outcomes after an acute ischaemic stroke. We aim to understand the combined effect of the collaterals and thrombus permeability on cerebral blood flow during an acute ischaemic stroke. A cerebral blood flo...

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Bibliographic Details
Published in:Journal of the Royal Society interface 2022-10, Vol.19 (195), p.20220649-20220649
Main Authors: Padmos, Raymond M, Arrarte Terreros, Nerea, Józsa, Tamás I, Závodszky, Gábor, Marquering, Henk A, Majoie, Charles B L M, Payne, Stephen J, Hoekstra, Alfons G
Format: Article
Language:English
Subjects:
Brain Ischemia - diagnostic imaging
Cerebrovascular Circulation - physiology
Humans
Ischemic Stroke
Life Sciences–Physics interface
Permeability
Stroke
Thrombosis
Treatment Outcome
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Summary:The presence of collaterals and high thrombus permeability are associated with good functional outcomes after an acute ischaemic stroke. We aim to understand the combined effect of the collaterals and thrombus permeability on cerebral blood flow during an acute ischaemic stroke. A cerebral blood flow model including the leptomeningeal collateral circulation is used to simulate cerebral blood flow during an acute ischaemic stroke. The collateral circulation is varied to capture the collateral scores: absent, poor, moderate and good. Measurements of the transit time, void fraction and thrombus length in acute ischaemic stroke patients are used to estimate thrombus permeability. Estimated thrombus permeability ranges between 10 and 10 mm . Measured flow rates through the thrombus are small and the effect of a permeable thrombus on brain perfusion during stroke is small compared with the effect of collaterals. Our simulations suggest that the collaterals are a dominant factor in the resulting infarct volume after a stroke.
ISSN:1742-5662
1742-5689
1742-5662
DOI:10.1098/rsif.2022.0649