It is critical to identify early predictors of functional outcome following an acute ischemic stroke (AIS). Arterial collaterals had been considered as a critical determinant of prognosis in stroke cases. The venous system has received less attention in clinical studies than the intracranial arterial system due to less prevalent disorders associated with them. The Internal cerebral veins (ICV) could serve as an indicator of compromised venous drainage which could also influence clinical outcomes. Thus this study aimed to determine the association of ICV status, clot burden, and collateral Status with AIS outcome.

This cohort study was carried out in the Department of Neurology and Radiology at a tertiary care hospital. In the study patients with large vessel occlusion(LVO) AIS were included. ICV status, collateral status using the regional leptomeningeal collateral score(rLMC), and clot burden score(CBS) were assessed on baseline CTA. Multivariate logistic regression analysis was used to determine independent predictors of poor outcome

A total of 72 AIS patients with LVO were included in this study with males comprising 58.3 %. The mean age was 59.56(14.69). The number of patients with ICV asymmetry was significantly higher in the poor outcome group(P<0.05). The rLMC and CBS scores were significantly lower in the poor outcome group(P<0.05). After multivariable analysis, ICV status and rLMC score emerged as independent predictors of poor outcome after adjusting the effect of all other variables with OR 0.125(0.024, 0.648) and 0.528(0.343, 0.812) respectively.

ICV asymmetry and leptomeningeal collateral status on baseline CTA are independent predictors of poor outcome