1 Vascular Anatomy of the Head and Neck/Circle of Willis * The relevant venous anatomy is covered in depth in Chapter 20

2022 ◽  
Keyword(s):  
Head And Neck ◽  
Vascular Anatomy ◽  
Circle Of Willis ◽  
Venous Anatomy

Abstract WP25: Gender Disparity in Mechanical Thrombectomy Outcomes: The Role of Arterial Caliber

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mark A Davison ◽  
Kavantissa M Keppetipola ◽  
Bichun Ouyang ◽  
Michael Chen
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Mechanical Thrombectomy ◽  
Vascular Anatomy ◽  
Gender Disparity ◽  
Circle Of Willis ◽  
Large Vessel ◽  
Consecutive Series ◽  
Anterior Circulation ◽  
Men And Women

Introduction: Despite level 1a evidence demonstrating the clinical benefit of mechanical thrombectomy in selected large vessel ischemic stroke patients, a gender disparity exists. Women not only have less favorable clinical outcomes after all stroke types, but the causes of this disparity remain elusive. Gender differences in cerebral vascular anatomy have been previously published. We hypothesize that differences in circle of Willis diameters may contribute to the gender disparity seen in clinical outcomes after mechanical thrombectomy for acute ischemic stroke. Methods: Clinical and radiographic data from a consecutive series undergoing mechanical thrombectomy for anterior circulation large vessel ischemic strokes were reviewed. Measurements of the proximal middle cerebral artery (M1) segment and supraclinoid internal carotid artery (ICA) diameters were obtained in a standardized fashion from the thrombectomy procedure angiogram. All M1 measurements were recorded at 3 mm of the vessel origin while ICA measurements were taken 3 mm proximal to the ICA terminus. Covariates included age, occlusion location, vascular risk factors, admission NIHSS score and final TICI grade. Modified Rankin score (mRS) at 90 days was the dependent variable. Variable significance between male and female cohorts was determined using student T-Tests. Multivariate regression analysis was also performed. Results: Ninety-four patients (41 female) between 6/2013 and 6/2016 fit the inclusion criteria. ICA terminus measurements for men and women were 3.07 mm (SD=0.46) and 2.88 mm (SD=0.47), respectively. M1 origin measurements for men and women were 2.46 mm (SD=0.31) and 2.21 mm (SD=0.37), respectively. Male ICA terminus and M1 origin measurements were larger than female (p = 0.05 and p < 0.001, respectively). 61% of men vs. 25% of women had 90-day mRS ≤ 2. Multivariate analysis indicated that only age was significantly associated with 90-day mRS ≤ 2. Conclusions: Our single center series suggests that differences in intracranial vessel diameter may contribute to the gender disparity in outcomes after mechanical thrombectomy. Smaller circle of Willis arterial diameters may compromise collateral blood flow and increase the difficulty in achieving sufficient reperfusion.

Variations in origin of the superior thyroid artery: an update for the head and neck surgeon

2021 ◽  
Vol 103 (7) ◽  
pp. e238-e239
Author(s):  
S Shaw ◽  
K Maharaj ◽  
T Mirza
Keyword(s):  
Head And Neck ◽  
Neck Dissection ◽  
Anatomical Variation ◽  
Vascular Anatomy ◽  
Carotid Bifurcation ◽  
Classification Systems ◽  
Superior Thyroid Artery ◽  
Radial Forearm ◽  
Level I ◽  
Partial Glossectomy

Head and neck surgeons must have a thorough knowledge of head and neck vascular anatomy and its variations. This case report documents a variation in the superior thyroid artery encountered during a neck dissection and discusses the surrounding literature. A 55-year-old female with squamous cell carcinoma of the tongue underwent a partial glossectomy, right level I–IV neck dissection and reconstruction with a radial forearm free flap. During the procedure, an arterial branch was encountered arising 2–3cm caudal to the common carotid bifurcation. This variant branch was shown to represent the superior thyroid artery. On review of the literature, various classification systems of the superior thyroid artery origin have been described. Awareness of such anatomical variation is vital for the head and neck surgeon to avoid unexpected complication.

Cutaneous Vascular Anatomy of Pectoral Skin Flaps

1973 ◽  
Vol 82 (5) ◽  
pp. 691-695
Author(s):  
Thomas C. Calcaterra ◽  
Edward F. Cherney ◽  
Mohammed Saffouri
Keyword(s):  
Head And Neck ◽  
Blood Supply ◽  
Surgical Therapy ◽  
Vascular Anatomy ◽  
Skin Flaps ◽  
Flap Necrosis ◽  
Arterial Blood Supply ◽  
Pedicled Flaps ◽  
Arterial Blood ◽  
Flap Viability

The need for nondelayed skin flaps from the chest for postoperative reconstruction and repair has increased considerably since the advent of combined irradiation and surgical therapy for treatment of cancer of the head and neck. Survival of these pedicled flaps is of paramount concern to the surgeon, as flap necrosis can be catastrophic for the patient. Many parameters have been evaluated to predict flap viability, but recent studies strongly suggest that the arterial blood supply of the pedicle is the most important factor in the success of immediate transposition. A study was performed in 19 cadavers to delineate the cutaneous vascular anatomy of the chest in order to determine precisely where the perforating vessels of the thorax and shoulders supply the pedicle region of medially-based and laterally-based pectoral flaps. On the basis of this study, modification of the design of these flaps is recommended.

Transoral robotic study of the vascular anatomy of the head and neck

2013 ◽  
Vol 8 (1) ◽  
pp. 57-61
Author(s):  
Neerav Goyal ◽  
Dhave Setabutr ◽  
David Goldenberg
Keyword(s):  
Head And Neck ◽  
Vascular Anatomy

scholarly journals Dr. Thomas Willis and his ‘Circle’ in the Brain

2005 ◽  
Vol 2 (1) ◽  
pp. 77-79 ◽  
Author(s):  
PVS Rana
Keyword(s):  
Medical Science ◽  
Vascular Anatomy ◽  
Circle Of Willis ◽  
Short Description ◽  
Accurate Description ◽  
Accurate Knowledge ◽  
Arterial Anastomosis ◽  
Intracranial Arteries ◽  
The Brain

With the advances in microneurosurgery and the ability to tackle diseases of the intracranial arteries at the base of the brain (often referred to as the Circle of Willis) surgically more effectively, accurate knowledge of the intracranial vascular anatomy is increasingly important. Although Dr. Thomas Willis is best remembered for the accurate description of arterial anastomosis at the baseof the brain, his contribution to neuroanatomy, physiology and medical science in general is vast, and several diseases bear his name. In this article an attempt has been made to review the life of Dr. Willis followed by a short description of the “Circle of Willis.” Nepal Journal of Neuroscience, Volume 2, Number 1, 2005, Page: 77-79

scholarly journals Recurrent artery of Heubner - morphological variations

2013 ◽  
Vol 19 (3) ◽  
pp. 141-146 ◽  
Author(s):  
Cr.P. Dimitriu ◽  
D.M. Iliescu ◽  
P. Bordei ◽  
I. Bulbuc
Keyword(s):  
Anterior Part ◽  
Anatomical Variation ◽  
Vascular Anatomy ◽  
Internal Capsule ◽  
Anatomical Variations ◽  
Neurological Complications ◽  
Circle Of Willis ◽  
Anterior Communicating Artery ◽  
Neurosurgical Procedures ◽  
Anterior Portion

Abstract Recurrent artery of Heubner (RAH) is the largest and most constant perforating branch of anterior cerebral artery. It supplies blood to the medial portion of the orbitofrontal cortex, the anterior portion of the caudate nucleus, the anterior third of the putamen, the external segment of the globus pallidus, and the anterior crus of the internal capsule The anatomical variation of RAH is related to its traject, number, presence, or absence, and the diverse origin from ACA is of considerable clinical impact mainly from the point of view of the surgical procedures involving the anterior portion of the circle of Willis or the topographically related structures. The present study aimed to demonstrate vascular anatomy of this RAH and its variation. The study included 60 human cadaveric brains fixed in the formalin and examined under operating microscope. 22 freshly harvested human cadaveric brains, injected with a polymer (Technovit 7143), a partial coroded and also we have consulted 30 digital subtraction angiograms. We have evaluated the origin, traject and caliber of recurrent artery of Heubner, our results were compared with other anatomical studies published. The most obvious finding was the great variability of its origin but in 91% of the cases it was in the range of 2mm around anterior communicating artery, that could be harmed during aneurismal clipping. The RAH is commonly arising from ACA-ACoA junction. This portion of the circle of Willis is the place of many anatomical variations and malformations. The vessel can be absent, single, or multiple, and its diameter is highly variable. The awareness of these distinct anatomical and morphometric variations of the RAH is essential in planning the neurosurgical procedures in the anterior part of the circle of Willis to avoid the unexpected neurological complications.

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