1/13/2024 0 Comments Circle of willis![]() Īlthough there are numerous studies on anatomical variations of the circle of Willis, presence of any association between anatomical variations of circle of Willis and incidence of ischemic stroke is still unclear. ![]() Some of the most common variations in the circle of Willis include hypoplasia or aplasia of one or both posterior communicating arteries (PCoA) (34 to 68%), hypoplasia or aplasia of the A1 segment of anterior cerebral artery (ACA) (4 to 10%), absence or fenestration of anterior communicating artery (ACoA) (12 to 21%), persistent fetal origin of posterior cerebral artery (fPCA) (4% to 26%), and infundibular dilatation or widening of PCoA (7% to 15%). Circle of Willis is the most important collateral system in the brain with multiple potential anatomical variations. In case of a major cerebral arterial occlusion, collateral vessels play an important role in maintaining essential blood flow. Īrteriogenesis is a complex embryologic process and can lead to numerous anatomical variations. Stroke risk factors include age, sex, race, hypertension, diabetes, hyperlipidemia, diet, smoking, and alcohol. Based on an Iranian systematic review in 2010, the annual stroke incidence among various ages ranged from 23 to 103 per 100,000 people. Seventy-five percent of all stroke deaths and 81% of the total disability adjusted life years lost due to stroke occur in developing countries. Stroke is a major cause of disability and the second leading cause of death worldwide. In patients with brain infarction, aplastic/hypoplastic ipsilateral PCoA is associated with higher incidence of thalamic territory infarction. In two subgroups with and without ipsilateral fPCA variation, frequency of infarction in brain territories was not different significantly. However, regarding the territories involved by infarction, the frequency of thalamus infarction was higher in subgroup with PCoA hypoplasia/aplasia, 17/101 (16.8%) compared to 1/41(2.4%) in the subgroup without ipsilateral PCoA hypoplasia/aplasia ( p = 0.024). No significant correlation was identified between fPCA or PCoA hypoplasia/aplasia and presence of infarction. Sixty-three patients (21/1%) had fPCA and 231 (77.5%) had PCoA hypoplasia/aplasia. In total, 298 patients (155 male/143 female with mean age ± SD of 57 ± 15) were enrolled in the study and categorized into two groups with infarction ( n = 142) and without infarction ( n = 156). The frequency of anatomical variations including persistent fetal origin of posterior cerebral artery (fPCA) and hypoplastic/aplastic posterior communicating artery (PCoA) and their association with infarction in different intracranial vascular territories was assessed. This cross-sectional study was conducted on consecutive patients who underwent brain MRI and MRA for suspected cerebrovascular accident. The purpose of this study was to evaluate the relationship between anatomical variations in posterior portion of the circle of Willis assessed by MR angiography (MRA) and ischemic infarction in different brain territories. The relationship between anatomical variations in circle of Willis and brain infarction is controversial.
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