Falougy H El, Weismann P, Lukacikova P, Mifkovic A, Perzelova A, Sivakova I, Kubikova E
Bratisl Lek Listy. 2018;119(11):679-683. doi: 10.4149/BLL_2018_122.
Various authors defined three patterns of the posterior part of the circulus arteriosus cerebri Willisi (CW) according to the diameter of the posterior communicating artery (PCoA) and the precommunicating segment of the posterior cerebral artery (P1). In the adult pattern, the P1 has a diameter larger than the non-hypoplastic PCoA. In the transitional pattern, the diameter of the PCoA is equal to that of the P1. In the fetal pattern, the diameter of the P1 is smaller than the diameter of the PCoA. The study was aimed to evaluate the configurations and calibers of the posterior part of the CW.
The work was conducted on 185 adult post-mortem brains. The CW and its branches were photographed by a digital camera. We used the software Image J to evaluate and process the gained images.
The fetal pattern was found unilaterally in 8.37 %, and bilaterally in 4.86 %. The transitional pattern was observed unilaterally in 6.47 %, and bilaterally in 1 %. The prevalence of the unilateral and bilateral adult patterns was equal (21.62 % for each configuration). The hypoplastic PCoA was found unilaterally in 17.57 %, and bilaterally in 16.76 %.
Various factors including genetic and environmental may affect the development of the cerebral vessels and their dimensions. The distinguishing of the vascular dimensions in vivo can help in the expectation and may be the avoidance of possible cerebrovascular disturbances in the future. Correlation and interdisciplinary cooperation of the studies dealing with morphology, radiology, and hemodynamics of the cerebral vessels are becoming an urgent need. The assumed results of this cooperation can be used in tabulating the calibers of the cerebral vessels and determining the threshold dimensions under which failure of hemodynamics and collateral function may appear (Tab. 2, Fig. 5, Ref. 28).
不同作者根据后交通动脉(PCoA)和大脑后动脉(P1)的交通前段直径,定义了大脑动脉环(Willis环,CW)后部的三种模式。在成人模式中,P1的直径大于非发育不全的PCoA。在过渡模式中,PCoA的直径等于P1的直径。在胎儿模式中,P1的直径小于PCoA的直径。本研究旨在评估CW后部的形态和管径。
对185例成人尸检脑进行研究。用数码相机拍摄CW及其分支。使用Image J软件评估和处理获取的图像。
发现胎儿模式单侧出现率为8.37%,双侧出现率为4.86%。过渡模式单侧出现率为6.47%,双侧出现率为1%。单侧和双侧成人模式的发生率相等(每种形态均为21.62%)。发育不全的PCoA单侧出现率为17.57%,双侧出现率为16.76%。
包括遗传和环境在内的多种因素可能影响脑血管的发育及其大小。在体内区分血管大小有助于预测,且可能避免未来可能出现的脑血管紊乱。涉及脑血管形态学、放射学和血流动力学研究的相关性和跨学科合作正变得迫切需要。这种合作的假定结果可用于制定脑血管管径表,并确定可能出现血流动力学和侧支循环功能衰竭的阈值大小(表2,图5,参考文献28)。