부산대학교 도서관

The cerebral arterial network covering the brain cortex has multiscale anastomosis structures with sparse intermediate anastomoses (O[102] μm in diameter) and dense pial networks (O[101] μm in diameter). Recent studies indicate that collateral blood supply by cerebral arterial anastomoses has an essential role in the prognosis of acute ischemic stroke caused by large vessel occlusion. However, the physiological importance of these multiscale morphological properties—and especially of intermediate anastomoses—is poorly understood because of innate structural complexities. In this study, a computational model of multiscale anastomoses in whole-brain-scale cerebral arterial networks was developed and used to evaluate collateral blood supply by anastomoses during middle cerebral artery occlusion. Morphologically validated cerebral arterial networks were constructed by combining medical imaging data and mathematical modeling. Sparse intermediate anastomoses were assigned between adjacent main arterial branches; the pial arterial network was modeled as a dense network structure. Blood flow distributions in the arterial network during middle cerebral artery occlusion simulations were computed. Collateral blood supply by intermediate anastomoses increased sharply with increasing numbers of anastomoses and provided one-order-higher flow recoveries to the occluded region (15%–30%) compared with simulations using a pial network only, even with a small number of intermediate anastomoses (≤10). These findings demonstrate the importance of sparse intermediate anastomoses, which are generally considered redundant structures in cerebral infarction, and provide insights into the physiological significance of the multiscale properties of arterial anastomoses. Author summary: The collateral blood supply in the cerebral arterial network that covers the brain cortex has an essential role in the prognosis of acute ischemic stroke caused by large vessel occlusion. However, these physiological functions remain poorly understood because of the structural complexities of cerebral arterial anastomoses (the source of collateral blood supply), which have multiscale properties (diameters 50–400 μm). Thus, we aimed to estimate the potential function of multiscale anastomoses in collateral blood supply during acute ischemic stroke using computational modeling. A sparse intermediate scale of anastomoses (O[102] μm in diameter) and a dense pial arterial network (O[101] μm in diameter) were constructed in the morphologically validated arterial network model (whole-brain scale); blood flow distributions in this arterial network were then computed using numerous patterns of intermediate anastomoses in the MCA occlusion. Obtained results successfully demonstrate that sparse numbers of intermediate anastomoses primarily provide collateral blood supply toward upstream and downstream regions and provide one-order-higher flow recoveries to the occlusion region compared with simulations with a pial network only. We hope that our findings stimulate further clinical and anatomical measurements of multiscale cerebral anastomoses. [ABSTRACT FROM AUTHOR]