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American Journal of Roentgenology, Vol 98, 637-646, Copyright © 1966 by American Roentgen Ray Society

CRANIAL COLLATERAL PATHWAYS IN STROKE SYNDROME

LEON LOVE M.D.1, B. J. HILL M.D.2, SANFORD J. LARSON M.D.3, A. J. RAIMONDI M.D.4, and ALFRED J. LESCHER M.D.5

1 Department of Diagnostic Radiology, Cook County Hospital, Chicago, Illinois
2 Department of Radiology, Presbyterian-St. Luke's Hospital, Chicago, Illinois
3 Department of Neurosurgery, Marquette University School of Medicine, Milwaukee, Wisconsin
4 Department of Neurosurgery, Cook County Hospital, Chicago, Illinois
5 Department of Radiology, Cook County Hospital, Chicago, Illinois

1. Cranial collateral circulation is consistently demonstrable by serial filming.

[See figure in the pdf file]

2. There are 3 principal cranial collateral pathways.

I. Circle of Willis.

II. External to internal carotid anastomoses via:

(a) Ophthalmic artery reversed flow (commonly observed)

(b) Middle meningeal branch of external carotid to the meningeal branches of the cerebral arteries (uncommonly demonstrated).

III. Over the surface of the brain, socalled meningeal or pial anastomoses between and among the 3 major cerebral arteries.

3. These collateral pathways exist awaiting demand, and enlarge as demand for flow rate and volume increases.

4. It is our impression that prognosis is related to the richness of demonstrable pathways.


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Copyright © 1966 by the American Roentgen Ray Society.