XXXX in proximal middle cerebral artery occlusion.

@entity1 @entity64 @entity2806 @entity1188 @entity955 @entity393
PURPOSE: Insula involvement in @entity2806 more likely causes @entity393 and poor clinical outcome than @entity1188 . Our objective was to prove the hypothesis that abundant collateral circulation represented by distal hyperintense vessels (HV) on MRI alleviates insula @entity1188 and facilitates prognosis. MATERIAL AND METHODS: One hundred and fourteen @entity64 cases with M1 totally occlusion on MR angiography were documented consecutively from 2012 to 2014. The degree of HV was graded as absent, subtle or prominent. Clinical data were recorded retrospectively by reviewing the medical records. The @entity1188 volume on diffusion-weighted image, along with National Institutes of Health @entity64 Scale (NIHSS) and modified Rankin Scale (mRS), was used to evaluate the clinical severity and prognosis. RESULTS: The degree of HV was more abundant in insula-uninvolved @entity64 compared with @entity64 involving insula @entity1188 (p  = 0.026). Insula-involved @entity64 @entity1 were older (p  = 0.039) with a higher percentage of @entity955 history (p  = 0.042). Univariate analysis revealed that insula @entity1188 , age, @entity1188 volume and NIHSS predicted unfavorable prognosis of @entity64 , whereas HV had a favorable effect. The protective effect of HV was confirmed by multivariate analysis. CONCLUSION: HV is a protective barrier between insula @entity1188 and severity of clinical symptoms among @entity64 @entity1 .
