Bio-clinical evaluation of collateral score in acute middle cerebral artery occlusion

Authors: ESRA DEMİR, HESNA BEKTAŞ, HASAN BAYINDIR, OĞUZHAN KURŞUN

Abstract: Background/aim: Acute ischemic stroke (AIS) is characterized as a neurological deficit owing to an acute focal damage to the brain by cerebral infarction. A collateral score is the most significant factor evaluating the prognosis of AIS, its relationship with demographic data, serum biochemical parameters, and clinical disability in this field. Materials and methods: We conducted a single-center retrospective study with 100 patients with AIS within the first 6 h of ischemic stroke. Data for consecutive AIS patients were collected from February 2019 to May 2020. The collateral score was assessed by using developed scoring systems defined by Maas et al. The correlations between collateral score and demographic data, biochemical parameters, NIHSS scores (National Institutes of Health Stroke Scale), mRS (modified Rankin scale) scores were recorded. Results: The research was performed in 100 patients (median age, 71.55 ± 11.46 years), and there was a statistically significant difference between elevated erythrocyte distribution width (RDW) and Maas collateral score (insular cortex) (p = 0.024) and lymphocyte/ monocyte ratio (LMO) and Maas collateral (leptomeningeal) score (p = 0.025). Conclusion: In patients with acute MCA M1 occlusion, our analysis found a significant association between elevated RDW, low LMO parameters, and collateral score. We assume that, in terms of simple and quick usability in acute stroke prognosis, these parameters are useful and functional as a new biomarker.

Keywords: Acute ischemic stroke, brain computed tomography angiography, collateral score, lymphocyte monocyte ratio, middle cerebral artery occlusion, RDW

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