Association between the posterior part of the circle of Willis and the vertebral artery hypoplasia
Autoři:
Virginija Gaigalaite aff001; Jurate Dementaviciene aff001; Augenijus Vilimas aff001; Danute Kalibatiene aff001
Působiště autorů:
Faculty of Medicine, Vilnius University, Vilnius, Lithuania
aff001
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0213226
Souhrn
Background
It is not clear whether the configuration of the posterior part of the circle of Willis (CW) depends on the proximal part of the vertebrobasilar system. Our aim is to evaluate the posterior part of CW in association with different size of vertebral arteries (VA) in healthy volunteers.
Materials and methods
The present study was based on a sample of 923 healthy volunteers who were examined from 2013 through 2018. The duplex ultrasonographic examination of the extracranial vertebral (VA) and carotid arteries was performed. VA was defined as hypoplastic (VAH) when VA diameter in the entire course was less than 2.5 mm. All the participants underwent magnetic resonance angiography (MRA) examination. All the component vessels of the circle of Willis were assessed in each individual. We classified the posterior communicating artery (PCoA) as presence PCoA, absence/hypoplastic PCoA and fetal-type posterior circle of Willis (FCW) in which the major stem of the posterior cerebral artery (PCA) arises from ipsilateral internal carotid artery (ICA). The comparison of the posterior part of CW was made in subjects with normal VA and VAH of a different degree (communicating with basilar artery (VAH-BA) and not communicating with the basilar artery (VAH-PICA)).
Results
FCW was found in 15.9% of subjects, bilaterally–in 2.3%. FCW was more frequent in individuals with VAH than in those with normal VA (accordingly, 28.8% vs. 13.5%, p<0.001. Moreover FCW was recorded in 50% of the subjects with VA—PICA in comparison with 13.5% of those with normal VA and 22.8% with VAH—BA, p<0.005. On the contrary, absence/hypoplasia of both PCoA was mostly found in the group with normal VA in comparison with VAH-BA and VAH-PICA (accordingly, 50.7%, 38.6% and 12.5%, p<0.01).
Conclusion
Individuals with VAH have a different pattern of the posterior part of CW in comparison with those with normal VA. With the increasing degree of VAH, the proportion of FCW increases, while the proportion of absence/hypoplastic of both PCoA decreases.
Klíčová slova:
Biology and life sciences – Anatomy – Cerebral arteries – Body fluids – Blood – Blood flow – Physiology – Medicine and health sciences – Cardiovascular anatomy – Blood vessels – Arteries – Carotid arteries – Diagnostic medicine – Diagnostic radiology – Magnetic resonance imaging – Radiology and imaging – Cardiovascular medicine – Cardiovascular imaging – Angiography – Neurology – Cerebrovascular diseases – stroke – Vascular medicine – Research and analysis methods – Imaging techniques
Zdroje
1. 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: 217–224. doi: 10.1159/000094007 16788293
2. Van Overbeeke JJ, Hillen B, Tulleken CA: A comparative study of the circle of Willis in fetal and adult life: the configuration of the posterior bifurcation of the posterior communicating artery. J Anat 1991; 176: 45–54. 1917674
3. Hakim A, Gralla J, Rozeik CH, Mordasini P, Leidolt L, Piechowiak E. Anomalies and Normal Variants of the Cerebral Arterial Supply: A Comprehensive Pictorial Review with a Proposed Workflow for Classification and Significance. J Neuroimaging 2017; 00:1–22.
4. Menshawi K, Mohr JP, Gutierrez J. A Functional Perspective on the Embryology and Anatomy of the Cerebral Blood Supply. J Stroke. 2015;17(2):144–58. doi: 10.5853/jos.2015.17.2.144 26060802
5. Lochner P, Gsolaszewski S, Caleri F, Ladurner G, Tezzon F, Zuccoli G, Nardone R. Posterior circulation ischemia in patients with fetal-type circle of Willis and hypoplastic vertebrobasilar system. Neurological sciences. 2011; 32: 1143–1146 doi: 10.1007/s10072-011-0763-5 21927884
6. Del Brutto OH, Mera RM, Costa AF, Del Brutto VJ. Basilar Artery Diameter Is Inversely Associated with Fetal Type Circle of Willis. Eur Neurol. 2017; 78(3–4): 217–220. doi: 10.1159/000480430 28903104
7. Gaigalaite V, Vilimas A, Ozeraitiene V et al., Association between vertebral artery hypoplasia and posterior circulation stroke. BMC Neurology. 2016; 16:118. Available from: https://bmcneurol.biomedcentral.com/track/pdf/10.1186/s12883-016-0644-x doi: 10.1186/s12883-016-0644-x 27461465
8. Krabbe-Hartkamp MJ, van der Grond J, de Leeuw FE, de Groot JC, Algra A, et al. Circle of Willis: morphologic variation on three-dimensional time-off light MR angiograms. Radiology 207: 1998; 103–111. doi: 10.1148/radiology.207.1.9530305 9530305
9. Chen YY, Chao AC, Hsu HY, Chung CP, Hu HH. Vertebral artery hypoplasia is associated with a decrease in net vertebral flow volume. Ultrasound Med Biol. 2010;36(1):38–43. doi: 10.1016/j.ultrasmedbio.2009.08.012 19900752
10. Szárazová AS, Bartels E, Turčáni P. Vertebral artery hypoplasia and the posterior circulation stroke. Perspectives in Medicine. 2012;1:98–202.
11. Katsanos AH, Kosmidou M, Giannopoulos S. Is Vertebral Artery Hypoplasia a Predisposing Factor for Posterior Circulation Cerebral Ischemic Events? A Comprehensive Review. Eur Neurol. 2013; 70:78–83. doi: 10.1159/000351786 23816871
12. Shaban A, Albright KC, Boehme AK, et al. Circle of Willis variants: Fetal PCA. Stroke Res Treat. 2013; 2013:1–7.
13. Abdelaziz Maaly M, Abdelazim Ismail A. Three dimensional magnetic resonance angiography of the circle of Willis: Anatomical variations in general Egyptian population. The Egyptian Journal of Radiology and Nuclear Medicine. 2011; 42, 405–412.
14. Li Qi, Li Jialun, Lv Fajin, Li Kewei, Luo Tianyou, Xie Peng. A multidetector CT angiography study of variations in the circle of Willis in a Chinese population Journal of Clinical Neuroscience. 2011; 18: 379–383. doi: 10.1016/j.jocn.2010.07.137 21251838
15. Thierfelder KM, Baumann AB, Sommer WH. Vertebral Artery Hypoplasia Frequency and Effect on Cerebellar Blood Flow Characteristics. Stroke. 2014; 45:1363–1368. doi: 10.1161/STROKEAHA.113.004188 24699051
Článek vyšel v časopise
PLOS One
2019 Číslo 9
- Případ Bulovka: Jak postupují jiné nemocnice, aby podobným tragédiím zabránily?
- Jak často se u masových střelců vyskytují duševní choroby?
- Zvoní budík? Přispěte si ještě chvilku, bude vám to myslet rychleji!
- FDA varuje před selfmonitoringem cukru pomocí chytrých hodinek. Jak je to v Česku?
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
Nejčtenější v tomto čísle
- Graviola (Annona muricata) attenuates behavioural alterations and testicular oxidative stress induced by streptozotocin in diabetic rats
- CH(II), a cerebroprotein hydrolysate, exhibits potential neuro-protective effect on Alzheimer’s disease
- Comparison between Aptima Assays (Hologic) and the Allplex STI Essential Assay (Seegene) for the diagnosis of Sexually transmitted infections
- Assessment of glucose-6-phosphate dehydrogenase activity using CareStart G6PD rapid diagnostic test and associated genetic variants in Plasmodium vivax malaria endemic setting in Mauritania
Zvyšte si kvalifikaci online z pohodlí domova
Všechny kurzy