scholarly journals Impact of gender and age on inner diameter of arteries forming circle of Willis assessed by multidetector CT

2021 ◽  
Vol 2 (1) ◽  
pp. 37-41
Author(s):  
Prakash Sharma ◽  
Subita Lalchan ◽  
Subhash KC ◽  
Merina Gyawali ◽  
Niraj Kushwaha

Introduction: The circle of Willis (CoW), which is located at the base of the brain is the most important anastomosis between the internal carotid and vertebral system. It is the main distributor of blood to the brain. Methods: CT head and CT angiography were performed using standard scan parameters. Only the tests with normal radiological reports and appropriate technical standards were included in the study. Component of circle of Willis: Anterior cerebral artery (ACA), Middle cerebral artery (MCA), Anterior communicating artery (Acom), Posterior Communicating artery (PCom), Basilar artery (BA) and Posterior cerebral artery (PCA) were identified and their internal diameter were measured. Results: Basilar artery was the artery with largest internal diameter with mean diameter of 2.5 ±0.52 mm. Men had significantly larger arterial sizes than women in all of the intracranial arteries examined except right PCom, Left PCom and right MCA. Right ACA had significantly larger internal diameter in <40 years’ age group. BA, left PCA, Bilateral PCom and MCA showed larger diameter in age group ≥40 years. Conclusion: Men had significantly larger arterial sizes than women in all of the intracranial arteries examined except right PCom, Left PCom and right MCA.

2016 ◽  
Vol 05 (01) ◽  
pp. 039-043
Author(s):  
Farheen A Karim ◽  
J D Sarma ◽  
K L Talukdar

AbstractThis report highlights an unusual variation of Anterior communicating artery of the circle of Willis found during dissection for studying circle of Willis. The brain was carefully extracted out of the skull so that arteries forming the circle of Willis do not get tom. The circle of Willis was identified in the interpeduncular cistern. Fine dissection was done to identify any variations. In this specimen there were double anterior communicating arteries joined in the midline by a short longitudinal segment of artery. Length and external diameters of both the Anterior communicating arteries were measured using Vernier calipers. Also, a medial striate artery (recurrent artery of Heubner) was seen originating from the right anterior cerebral artery just between the junctions of the proximal and distal Anterior communicating arteries with the right Anterior cerebral artery. Knowledge of this variation is valuable to neurosurgeons in planning surgical treatment and has clinical significance in relation to stroke.


2018 ◽  
Vol 46 (1) ◽  
pp. 9
Author(s):  
Rodrigo Cavalcanti De Azambuja ◽  
Laura Ver Goltz ◽  
Rui Campos

Background: The nutria (Myocastor coypus) is a medium-size, semi-aquatic rodent, valued in skin and meat industry. The brain circulation has been well studied in rodents but not in nutria. To understand and compare the phylogenetic development of the arteries of the base of the brain in rodents, this paper aims to describe and systematize these arteries, establishing a standard model and its main variations in nutria.Materials, Methods & Results: Following approval by the Ethics Committee of Federal University of Rio Grande do Sul, thirty nutrias from a commercial establishment authorized by Brazilian Institute of Environment and Natural Resources (IBAMA) were studied. For euthanasia, was applied heparin (10000 U.I for animal), intraperitoneally, and after thirty minutes the animals ware sedated with acepromazine (0.5 mg/kg) and meperidine (20 mg/kg), intramuscularly. After sedation, they were euthanized with thiopental sodium (120 mg/kg) and lidocaine (10 mg/mL), intraperitoneally. The heart was accessed, the cardiac apex was sectioned, the aorta was cannulated via the left ventricle and clamped close to the diaphragm, and the arterial system was washed with saline solution and filled with latex. The animals were submerged in water for latex polymerization, the trunk was sectioned, the skin removed and a bony window was opened in the skull vault. The pieces were fixed in formaldehyde. The brains were removed, and schematic drawings of the arteries from the base of the brain were made for elaboration of the results. The nutria’s brain was vascularized by the vertebro-basilar system. The terminal branches of the right and left vertebral artery were anastomosed on the ventral surface of the medulla oblongata, forming the basilar artery, and caudally the ventral spinal artery. The basilar artery formed collateral branches, the caudal and middle cerebellar and trigeminal arteries, and at the height of the rostral pons groove, divided into its two terminal branches, the rostral cerebellar and cerebral caudal arteries. The terminal branches of the basilar artery projected rostrally, forming the hypophyseal and rostral choroid arteries. The basilar artery passed the optic tract and bifurcated in the middle cerebral artery, its last collateral branch, and in the rostral cerebral artery, its terminal branch. The rostral cerebral artery formed the medial branch, closing the cerebral arterial circle caudally in 40% of the cases.Discussion: In rodents, variability of the cerebral arterial circle was observed due to the degree of atrophy of the internal carotid artery. The basilar artery was a rectilinear vessel of great caliber in all described rodents, and in rodents with a vertebro-basilar system, it was divided into its terminal branches after crossing the pons, forming the rostral cerebellar, hypophyseal, rostral choroid, caudal, middle and rostral cerebral arteries. The caudal cerebellar artery had variation of origin and sometimes duplication. The median cerebellar artery, a collateral branch of the caudal cerebellar artery, was a branch of the basilar artery in capybara. The caudal cerebral artery had variations between rodents. In capybara, chinchilla and nutria the middle cerebral artery was the collateral branch of the terminal branches of the basilar artery, and distributed on the convex surface of the cerebral hemisphere. The rostral cerebral artery, a branch of the terminal branch of the basilar artery, was a branch of the internal carotid artery in other rodents, forming the medial branch, which was anastomosed with that of the opposite antimer, when present, forming the rostral communicating artery. In nutria, the cerebral arterial circle was closed caudally in all cases, as in other rodents, however, it was opened rostrally in 60% of cases, compared to 70% in chinchilla and 10% in capybara.


2013 ◽  
Vol 19 (3) ◽  
pp. 147-153
Author(s):  
Cr.P Dimitriu ◽  
C. Ionescu ◽  
P. Bordei ◽  
I. Bulbuc

Abstract Background and purpose:limited data exist to guide proper patient selection for preventive treatment of unruptured cerebral aneurysms. Cerebral aneurysms have been associated with anomalies of arterial segments that are forming the brain arterial circle of Willis but whether this association is also related to aneurysm rupture is not known. The occurrence of cerebral aneurysm rupture when a circle of Willis anomaly was present or absent was compared. Material and methods: we have performed this study on a number of 312 cases, of which 87 were dissections, 22 dissection followed by plastic injection, 135 magnetic resonance angiography (MRA), 75 computer tomography angiography (CTA), 40 digital subtraction angiographies (DSA), 30 in vivo (intraoperatory) observation. Brain vascular imaging was reviewed for aneurysm size, morphology and presence of anterior cerebral artery anomalies. Results: we divided the study group in 2 cohorts, one control group of 272 cases, in which we have study the anatomical variants occurrence and aneurysm occurrence in general population and another included 45 patients admitted thru emergency room for subarachnoid hemorrhage, of those 38 were ruptured aneurysm of anterior communicating artery (ACoA). Mean aneurysm size was 8.9 mm. An anterior cerebral artery anomaly was identified in 31 cases (81.5%). Multivariate analysis revealed a higher risk of aneurysm rupture when an anterior cerebral artery was present. Conclusions: this study shows that anterior cerebral artery anomalies are more commonly found in ruptured as opposed to unruptured ACoA aneurysms. The presence of an ACA anomaly may be an important characteristic for selecting patients for preventive aneurysm treatment.


2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Soe Ei Phyu ◽  
Zunariah Buyong ◽  
Radhiana Hassan ◽  
Jamalludin A. Rahman ◽  
Siti Kamariah Che Mohamed

Introduction: The anterior communicating artery (ACoA) complex of the cerebral circulation, an area with great anatomical diversity, forms part of the communicating arterial supply to the brain. As brain tissues are susceptible to ischemic death, knowledge of this variability is important in diagnosis and management of diseases affecting brain circulation. The aim of the study is to measure the prevalence and to describe these variations. Methods: All patients who underwent CT angiography (CTA) scanning in HTAA from January 2009 to August 2015 were selected. A cross-sectional study was done to study these variations in 81 reconstructed CTA images. Results: Eleven types of variations were described (typical pattern; hypoplasia, aplasia, and duplication of ACoA; hypoplasia, and aplasia of A1 segment of the anterior cerebral artery (ACA); hypoplasia, and aplasia of A2 segment of ACA; A2 segments of ACA arising from a common trunk; the third A2 segment; bihemispheric ACA). A1 segment is the part of ACA from the internal carotid artery to ACoA, and A2 segment is the part of ACA from ACoA to the junction between the rostrum and genu of the corpus callosum. The typical pattern was seen in 35.8%, and the cases with other variation types constituted 64.2%, which is higher compared to previous studies. The variations in ACoA alone were 43.2%, and the most common variation was the ACoA aplasia, accounting for 28.4%. Conclusions: This study shows the high prevalence of anatomical variations in the ACoA complex, and the probable difference of this figure in different populations.


1999 ◽  
Vol 23 (1) ◽  
pp. 59-66
Author(s):  
Khalid Kamil Kadhum

The brain of the sheep receives its blood supply through the carotid rete and the basilar artery. The carotid rete formed of contribution of internal carotid artery and branches from maxillary artery. The internal carotid artery courses on the ventral surface of the cerebal crus to give the rostral cerebal artery and the caudal communicating artery . Thus , arteries excepted the middle cerebal artery forming with the same arteries of the opposite side , the cerebal arterial circle or circle of Willis. The internal caroted artery also gives off hypophysialartery to the  1999 ind, (1) swell, ügymielly wel dati', il pellilendiambell ileti  hypophysis. The caudal communicating artery give off the caudal cerebal artery and the rostral cerebellar artery and unite with the corresponding artery of the opposite side to form the basilar artery rostral to the pone . The basilar artery gives off the pontine artery , caudal cerebellar artery and the medullary branch. 


2017 ◽  
Vol 4 (4) ◽  
pp. 1249 ◽  
Author(s):  
Ramanuj Singh ◽  
Ajay Babu Kannabathula ◽  
Himadri Sunam ◽  
Debajani Deka

Background: The circle of Willis (CW) is a vascular network formed at the base of skull in the interpeduncular fossa. Its anterior part is formed by the anterior cerebral artery, from either side. Anterior communicating artery connects the right and left anterior cerebral arteries. Posteriorly, the basilar artery divides into right and left posterior cerebral arteries and each join to ipsilateral internal carotid artery through a posterior communicating artery. Anterior communicating artery and posterior communicating arteries are important component of circle of Willis, acts as collateral channel to stabilize blood flow. In the present study, anatomical variations in the circle of Willis were noted.Methods: 75 apparently normal formalin fixed brain specimens were collected from human cadavers. 55 Normal anatomical pattern and 20 variations of circle of Willis were studied. The Circles of Willis arteries were then colored, photographed, numbered and the abnormalities, if any, were noted.Results: Twenty variations were noted. The most common variation observed is in the anterior communicating artery followed by some other variations like the Posterior communicating arteries, Anterior cerebral artery and posterior cerebral artery (PCA) was found in 20 specimens.Conclusions: Knowledge on of variations in the formation of Circle of Willis, all surgical interventions should be preceded by angiography. Awareness of these anatomical variations is important in the neurovascular procedures.


2000 ◽  
Author(s):  
Ryuhei Yamaguchi ◽  
Susumu Kudo ◽  
Hiroyuki Yamanobe ◽  
Mikio Nakajima ◽  
Hiroshi Ujiie

Abstract The aneurysm in the cerebral artery is apt to initiate around the “Circle of Willis”. The anterior communicating artery (ACoA), which composes one of major part of the circle of Willis, is the most predilection artery of the aneurysm. This artery is characterized by a singular geometry. At this artery, two proximal anterior cerebral arteries (A1, confluence) join facing each other. Just at this artery, the flow bifurcates two distal anterior cerebral arteries (A2, bifurcation). Namely, this artery has a function as a bypass channel. Therefore, the flow around the anterior communicating artery would be very unstable. The aneurysm arises around the apex of this artery where the confluent flow collides.


Author(s):  
H Liu ◽  
X Wu ◽  
Y Xing ◽  
K Liu ◽  
H Zhang

Background: Cerebral artery stenosis is an important risk factor for ischemic strokes. This study aims to explore intracranial and extracranial artery stenosis in a large northeast Chinese cohort. Methods: We recruited 14793 outpatients and hospitalized patients to identify cerebral artery stenosis. Artery stenosis screening was done with transcranial Doppler (TCD) for intracranial arteries and carotid duplex sonography for extracranial arteries. Results: More intracranial than extracranial artery stenoses were identified (4255 versus 2809, i.e. 28.8% versus 19.0%, P<0.05). Similarly, mere intracranial stenosis was significantly more common than extracranial artery stenosis in this population (2632 versus 1186, i.e. 17.8% versus 8%, P<0.05). Among all identified intracranial arteries stenoses, the proportion of middle cerebral artery (MCA) stenosis was the highest. More intracranial than extracranial artery stenoses was seen within each age group, and rates of both increased with age. Intracranial and extracranial artery stenosis was more frequently identified in males than females. Conclusions: Incidence of cerebral artery stenosis in the population increases with age. Intracranial artery stenosis is more common than extracranial artery stenosis and the MCA stenosis accounted for the highest proportion, within each age group. More males suffer from intracranial or extracranial artery stenosis than females.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
M Fareed K Suri ◽  
Shahram Majidi ◽  
Joyce Meints ◽  
Afshin A Divani ◽  
Adnan I Qureshi

BACKGROUND There is little data about extraluminal protruding plaques in intracranial arteries. Such plaques may not cause luminal stenosis and may be undetectable by standard angiographic modalities. It is important to identify the prevalence of such plaques because these plaques may be a cause of thrombosis and ischemic events in patients with cryptogenic strokes. OBJECTIVE To identify the prevalence of extraluminal protruding plaques in intracranial arteries from autopsy specimens of Nun Study. METHODS A random sample of 54 specimens was selected from Nun Study repository of post-mortem intracranial arteries (Circle of Willis). The Nun Study is a longitudinal study of aging and Alzheimer's disease funded by the National Institute on Aging including 678 participants who are 75 to 106 years of age. Basilar artery and proximal middle cerebral arteries were inspected and arteries with plaques were identified. The specimens were placed in a liquid container and an angiographic catheter was placed in vessel of interest. Using iodinated contrast media and Ziehm Vista C-arm, angiography was obtained in multiple planes. Percentage luminal stenosis was measured using normal proximal or distal segment of the vessel as reference. Using microscopic images, extraluminal protruding plaques was then sequentially measured. Percentage increase in extraluminal wall diameter was calculated as (extraluminal diameter at plaque site - normal diameter)/normal diameter x100. RESULTS Out of 162 samples, plaques were identified in 126 samples. The characteristics of the plaques are tabulated. The percentage increase in extraluminal wall diameter was 10.33 ± 8.13. For vessel with angiographically occult plaques, the percentage increase in extraluminal wall diameter was 9.2±3.2. In extraluminal protruding plaques, the median protrusion was 0.3 mm and maximum protrusion was 0.9 mm. There was no difference between the percentage extraluminal protrusion between the middle cerebral (0.3±0.1) and basilar artery plaques (0.36±0.2), p=0.8. The frequency of extraluminal plaques without angiographic stenosis of any severity was higher than extraluminal plaques with angiographic stenosis (52% and 56% for middle cerebral artery and basilar artery, respectively). CONCLUSIONS There appears to be a high prevalence of extraluminal protruding plaques among elderly persons and most of these plaques are not detected by angiography. Newer, imaging modalities like vessel wall high resolution visusalization by magnetic resonance imaging may help identify the prevalencc and ischemic event risk associated with such plaques.


2013 ◽  
Vol 19 (4) ◽  
pp. 461-465 ◽  
Author(s):  
Keiji Sogawa ◽  
Yoichi Kikuchi ◽  
Toshihiro O'Uchi ◽  
Michihiro Tanaka ◽  
Tomio Inoue

Fenestration of the basilar artery (BA) is a rare variant of the intracranial artery, well demonstrated in autopsy and angiographic studies. Some angiographic series show a high incidence of associated aneurysms at the basilar fenestration site. The purpose of this study is to report the incidence of BA fenestration, its configurations, associated aneurysms, and arterial anomalies in a large series of intracranial MR angiograms (MRAs). A total of 16,416 MRAs were retrospectively reviewed to identify the location, size and associated intracranial arterial anomalies of BA fenestrations. All images were obtained with the time-of-flight (TOF) technique. Of the 16,416 MRAs, 215 fenestrations were found in 212 cases (1.29%). Most fenestrations were located in the proximal BA. The average length of the fenestration was 4.6 mm; the largest was 15.6 mm. No aneurysm was found at the site of the fenestration. Thirteen aneurysms were found in nine cases at locations other than the BA: seven in the middle cerebral artery (MCA), one in the anterior cerebral artery (ACA), one in the anterior communicating artery (Acom), one in the vertebral artery (VA), one at the carotid siphon, and two at the internal carotid-posterior communicating artery (IC-PC). Arterial anomalies in other locations were found in 26 cases. BA fenestrations were found in 1.29% of the 16,416 cases studied. There were no aneurysms at the BA fenestration site. Aneurysms at the BA fenestration site may be an exceedingly rare phenomenon.


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