Deans' stroke musings: Prediction of collateral circulation grading and functional outcomes in acute ischemic stroke using FLAIR vascular hyperintensity combined with multimodal CT parameters

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, February 2, 2026

Prediction of collateral circulation grading and functional outcomes in acute ischemic stroke using FLAIR vascular hyperintensity combined with multimodal CT parameters

Predictions DO NOTHING FOR STROKE RECOVERY, and with NO protocols written, COMPLETELY FUCKING USELESS! You're fired! All the mentors and senior researchers need to be fired for not having an objective of writing EXACT rehab protocols from research!

Prediction of collateral circulation grading and functional outcomes in acute ischemic stroke using FLAIR vascular hyperintensity combined with multimodal CT parameters

Qiushi Yang^1,2

Yanxin Ma²^*

Xin Qu^1,2

Yu Chen^1,2

Hui Sun^1,2

Gang Yao²

¹Mudanjiang Medical University, Mudanjiang, Heilongjiang, China
²Department of Radiology, Daqing Oilfield General Hospital, Daqing, Heilongjiang, China

Background/objectives: The variability in acute ischemic stroke (AIS) outcomes is closely associated with collateral circulation status. While fluid-attenuated inversion recovery vascular hyperintensity (FVH) and multimodal CT parameters (e.g., rLMC score, rCBV) were associated with 90-day functional outcomes in AIS patients, their combined predictive value and clinical utility warrant further investigation. This study investigates the combined predictive value of FVH and multimodal CT parameters for collateral assessment and prognosis in AIS.

Methods: We retrospectively and consecutively enrolled AIS patients with internal carotid artery or middle cerebral artery stenosis/occlusion who did not receive intravenous thrombolysis or mechanical thrombectomy. All patients underwent one-stop CT angiography–CT perfusion and multimodal MRI within 72 h of symptom onset. Evaluations included FVH scores (based on modified ASPECTS regions), rLMC scores, Maas scores, and ASITN/SIR collateral grading. Spearman analysis assessed correlations between FVH and CTA collateral scores. Univariate and multivariate logistic regression indicated the independent predictors of a 90-day functional outcome [favorable (mRS 0–2) vs. poor (mRS 3–6)], with receiver operating characteristic (ROC) curves evaluating predictive performance.

Results: The cohort comprised 112 patients (70 favorable outcomes, 42 poor outcomes). FVH scores showed a negative correlation with ASITN/SIR collateral grades (r = −0.432, p < 0.001). Compared to the favorable outcome group, the poor outcome group exhibited higher baseline National Institute of Health Stroke Scale (NIHSS) scores, elevated FVH scores, reduced rLMC scores, and lower rCBV values (all p < 0.05). Multivariate analysis indicated that NIHSS score, FVH score, rLMC score, and rCBV were independent predictors of poor outcomes. ROC analysis demonstrated strong predictive performance for rLMC score (AUC = 0.848, 95%CI 0.778–0.919), FVH score (AUC = 0.662, 95%CI 0.550–0.774), and rCBV (AUC = 0.727, 95%CI 0.631–0.822).

Conclusion: Multimodal CT combined with MRI facilitates early AIS diagnosis and collateral assessment. The integration of FVH with CT parameters (rLMC score and rCBV) was associated with the prediction of functional outcomes in AIS patients.