Published Online
on October 23, 2003

A more recent version of this article appeared on November 1, 2003

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Submitted on March 24, 2003
Accepted on March 28, 2003

Anatomy and Functionality of Leptomeningeal Anastomoses. A Review

Mariana Brozici MD^*; Albert van der Zwan MD, PhD; and Berend Hillen MD, PhD

From the Departments of Functional Anatomy (M.B.) and Neurosurgery (A. van der Z.), University Medical Center Utrecht, Utrecht, and Department of Anatomy, University Medical Center Nijmegen, Nijmegen (B.H.), Netherlands.

^* To whom correspondence should be addressed. E-mail: m.brozici{at}med.uu.nl.

Background--This review seeks to provide a structured presentation of existing knowledge of leptomeningeal anastomoses from anatomic and functional points of view and to identify problems and possible research directions to foster a better understanding of the subject and of stroke mechanisms.

Summary of Review--Available data show that leptomeningeal anastomoses may be important in understanding stroke mechanisms and that leptomeningeal anastomoses play an important role in penumbra outcome. However, the literature shows no consensus between statements on the existence of leptomeningeal anastomoses and compensatory capacity.

Conclusions--By analyzing the available literature and identifying the factors that contribute to this confusion, we found that variability and the functional consequences thereof are important but that quantitative data are lacking. Moreover, vascular remodeling is an issue to consider.

Key words: arterial occlusive diseases • collateral circulation • meningeal arteries

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