Leptomeningeal Collaterals in Acute Ischemic Stroke

Abstract

Introduction: The leptomeningeal collaterals are a subsidiary network of vascular channels that act as anastomotic channels in conditions
where cerebral blood flow is pathologically altered. These secondary collateral pathways may be utilized when collateral flow through
the circle of Willis is inadequate.
Summary of Review: The review highlights the importance of leptomeningeal (pial) anastomoses in the brain especially in conditions of
hemodynamic impairment such as ischemic stroke. The historical perspective regarding the role of these vessels is discussed. New advancements in the diagnostic and treatment modalities for the evaluation and optimization of these vessels are identified.
Conclusion: Evaluation and optimization of the leptomeningeal collaterals in ischemic stroke represents an important venue in prevention and treatment of cerebral ischemia