{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:09:44Z","timestamp":1790730584559,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The relevance of the brush-sign remained poorly documented in large vessel occlusion (LVO). We aimed to assess the relationship between the brush-sign and collateral status and its potential impact on baseline diffusion-weighted imaging\u2013Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) in acute ischemic stroke (AIS) patients eligible to mechanical thrombectomy (MT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients admitted in the Lyon Stroke Center with anterior circulation AIS due to intracranial internal carotid artery (ICA) and\/or M1 or M2 segment of the middle cerebral artery (MCA) occlusion eligible for MT were included. The brush-sign was assessed on T2-gradient-echo MRI. Collateral status was assessed on digital subtraction angiography according to the American Society of Interventional and Therapeutic Neuroradiology\/Society of Interventional Radiology (ASITN\/SIR) score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, 504 patients were included, among which 171 (33.9%) patients had a brush-sign. Patients with a brush-sign more frequently had a poor collateral status [72 (42.1%) vs. 103 (30.9%); <jats:italic>p<\/jats:italic> = 0.017]. In univariable analysis, a DWI-ASPECTS &amp;lt; 7 was associated with a brush sign. Following multivariable analysis, the brush-sign no longer affected DWI-ASPECTS &amp;lt; 7 while the latter remained associated with younger age [odds ratio (OR) 0.97, 95% CI.96\u20130.99], male sex (OR 1.79, 95% CI 1.08\u20132.99), a higher National Institutes of Health Stroke Scale (NIHSS) score (OR 1.16, 95% CI 1.1\u20131.21), a poor collateral status (OR 9.35, 95% CI 5.59-16.02), MCA segment (OR 2.54, 95% CI 1.25\u20135.38), and intracranial ICA (OR 3.01, 95% CI 1.16\u20138) occlusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The brush-sign may be a marker of poor collateral status but did not independently predict a lower DWI-ASPECTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p><jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>, identifier: NCT04620642.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.828256","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T05:25:11Z","timestamp":1646198711000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Does the Brush-Sign Reflect Collateral Status and DWI-ASPECTS in Large Vessel Occlusion?"],"prefix":"10.3389","volume":"13","author":[{"given":"Lucie","family":"Rascle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Bani 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