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Unlike a conventional cerebral angiogram, this technique visualizes pial arterial filling in all vascular territories, thereby providing additional hemodynamic information. Ours was a retrospective study of consecutive patients with ischemic stroke and M1 middle cerebral artery +\/\u2013 intracranial internal carotid artery occlusions presenting to our center from June 2010 and undergoing dynamic time-resolved CTA and perfusion CT within 6 hours of symptom onset. Leptomeningeal collateral status was assessed by determining relative prominence of pial arteries in the ischemic region, rate and extent of retrograde flow, and various topographical patterns of pial arterial filling. Twenty-five patients were included in the study. We demonstrate the existence of the following novel properties of leptomeningeal collaterals in humans: (a) posterior (posterior cerebral artery (PCA)\u2013MCA) dominant collateralization, (b) intra-territorial \u2018within MCA region\u2019 leptomeningeal collaterals, and (c) significant variability in size, extent, and retrograde filling time in pial arteries. We also describe a simple and reliable collateral grading template that, for the first time on dynamic CTA, incorporates back-filling time as well as size and extent of collateral filling.<\/jats:p>","DOI":"10.1038\/jcbfm.2012.171","type":"journal-article","created":{"date-parts":[[2012,11,14]],"date-time":"2012-11-14T04:03:44Z","timestamp":1352865824000},"page":"365-371","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":158,"title":["Assessment of Leptomeningeal Collaterals Using Dynamic CT Angiography in Patients with Acute Ischemic Stroke"],"prefix":"10.1177","volume":"33","author":[{"given":"Bijoy K","family":"Menon","sequence":"first","affiliation":[{"name":"Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billy","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Neurology and Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bivard","sequence":"additional","affiliation":[{"name":"Department of Neurology and Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil J","family":"Spratt","sequence":"additional","affiliation":[{"name":"Department of Neurology and Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M","family":"Demchuk","sequence":"additional","affiliation":[{"name":"Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand","family":"Miteff","sequence":"additional","affiliation":[{"name":"Department of Neurology and Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuewen","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Levi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W","family":"Parsons","sequence":"additional","affiliation":[{"name":"Department of Neurology and Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,11,14]]},"reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2564"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.595256"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000086465.41263.06"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.552513"},{"key":"e_1_3_1_6_2","first-page":"1789","article-title":"Angiographic assessment of pial collaterals as a prognostic indicator following intra-arterial thrombolysis for acute ischemic stroke","volume":"26","author":"Christoforidis GA","year":"2005","unstructured":"Christoforidis GA, Mohammad Y, Kehagias D, Avutu B, Slivka AP. 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