Trushel N.A.
Variations in the structure of circle of Willis in people with cerebral circulation disorders who died from other reasons
Abstract.
Objectives. To establish the variations in the structure of circle of Willis in people with cerebral circulation disorders who died from other reasons for the identification of variants predisposing to cerebrovascular disease development.
Material and methods. Variations in the structure of circle of Willis were studied on the brains of 500 deceased humans whose cause of death was not associated with cerebral ischemia and by means of computerized tomography in 100 people with this pathology.
Results. In 38% of cases the circle Willis in persons whose cause of death was not associated with cerebral circulation disorders was in its classical variant, in 19% of cases posterior trifurcation of internal carotid artery was observed, in 17,5% of cases - aplasia of the posterior connecting artery, in 11,5% «rare variants» were observed and 14% of cases belonged to a combined type. No cases of classical variant of circle of Willis were revealed in individuals with cerebral circulation disorders. Among the atypical (non-classical) variations most commonly were found: aplasia of one (25%) or two (21%) posterior connecting arteries, posterior trifurcation of internal carotid artery (26%) and the combined type of the circle of Willis (28% of cases).
Thus, for regulation of blood flow in the brain the classic version of the structure of the circle of Willis is the best. Nonclassical variants of arterial circle, especially aplasia of both posterior connecting arteries, can predispose to the development of circulatory disturbances in the brain.
Key words: brain, circle of Willis, arteries.
References
1. Mit'kovskaia NP, Dukor DM, Gerasimenok DS. Ostryi koronarnyi sindrom, oslozhnennyi ishemicheskim povrezhdeniem golovnogo mozga [The acute coronary syndrome complicated by ischemic injury of a brain]. Meditsinskii zhurnal. 2008;(3):13-6.
2. Gorbunov AB. Klinicheskoe znachenie razobshchennosti arterial'nykh kollateralei golovnogo mozga cheloveka [Clinical value of dissociation of arterial collaterals of a brain of the person]. V: Chelovek i lekarstvo: materialy XIII Ros. nats. kongr., Moskva, 3-7 apr. 2006 g. Moscow, RF; 2006. р. 106-107.
3. Fedorov OO, Gorbunov AB. Stroenie arterial'nogo kruga bol'shogo mozga cheloveka pri tserebrovaskuliarnykh rasstroistvakh [Structure of an arterial circle of a big brain of the person at cerebrovascular disorders]. V: Chelovek i lekarstvo: materialy XIV Ros. nats. kongr., Moskva, 15-20 apr. 2007 g. Moscow, RF; 2007. р. 146.
4. Trushel NA, Pivchenko PG. Rol' morfologicheskogo i gemodinamicheskogo faktorov v aterogeneze sosudov villizieva kruga [Role of morphological and hemodynamic factors in atherogenesis, vascular circle of Willis]. Minsk, RB: BGMU; 2013. 180 р.
5. van Raamt AF, Mali WP, van Laar PJ, van der Graaf Y. The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation. Cerebrovasc Dis. 2006;22(4):217-24.
6. Hoksbergen AW, Legemate DA, Csiba L, Csáti G, Síró P, Fülesdi B. Absent collateral function of the circle of Willis as risk factor for ischemic stroke. Cerebrovasc Dis. 2003;16(3):191-8.
7. Bazowski P, Ladziński P, Gamrot J, Rudnik A, Baron J. Aneurysms of the anterior communicating artery and anomalies of the anterior communicating artery part of the circle of Willis. Neurol Neurochir Pol. 1991 Jul-Aug;25(4):485-90.
8. Chuang YM, Liu CY, Pan PJ, Lin CP. Anterior cerebral artery A1 segment hypoplasia may contribute to A1 hypoplasia syndrome. Eur Neurol. 2007;57(4):208-11.
9. De Silva KR, Silva R, Gunasekera WS, Jayesekera RW. Prevalence of typical circle of Willis and the variation in the anterior communicating artery: a study of a Sri Lankan population. Ann Indian Acad Neurol. 2009 Jul;12(3):157-61.
10. Schomer DF, Marks MP, Steinberg GK, Johnstone IM, Boothroyd DB, Ross MR, Pelc NJ, Enzmann DR. The anatomy of the posterior communicating artery as a risk factor for ischemic cerebral infarction. N Engl J Med. 1994 Jun 2;330(22):1565-70.
