Pentyala Suneetha, Sankar K Devi, Bhanu P Sharmila, Kumar N S Sampath
Department of Radiology, Narayana Medical College, Nellore, India.
Department of Anatomy, Narayana Medical College, Nellore, India.
Anat Cell Biol. 2019 Mar;52(1):43-47. doi: 10.5115/acb.2019.52.1.43. Epub 2019 Mar 29.
Pre-communicating or A1 segment of anterior cerebral artery (A1ACA) hypoplasia can negotiate the anterior cerebral circulation. Not many studies have been examined the association of hypoplastic A1ACA and cerebral ischemic stroke (CIS). In this study the authors' want to accomplish the relationship between hypoplastic A1ACA and outcomes among the patients with CIS in Andhra Pradesh population of India. Retrospective review of prospectively identified 201 adult patients with CIS from 2015 to 2017 was achieved. Patients underwent 3.0T intracranial magnetic resonance angiography were compared with clinical and radiological aspects between male and female cases of A1ACA hypoplasia with associated variations in the circle of Willis. The obtained data was statistically analysed using SPSS software version 16.0 for Windows and -value <0.05 was considered as significant. Chi-square test was applied to find out the association between the sex and incidence of hypoplastic A1ACA. Sixty-four of 201 patients with A1ACA hypoplasia with no aplastic cases were recorded. It was found to be more in males than females and common on right than left side. Frequent neurological indications such as headache, dizziness, visual instability, nausea, weakness of extremities and seizure were noted and most cases were associated with CIS. Hypoplastic A1ACA often associated with ischemia of terminal branches of ipsilateral ACA which is compromised by the blood flow via contralateral ACA. In this study, though the CIS is not directly related to hypoplastic A1ACA, any alterations in A1 segment is a considerable risk factor of stroke.
大脑前动脉(A1段)的预沟通型或发育不全可代偿大脑前循环。目前对发育不全的A1段大脑前动脉与脑缺血性卒中(CIS)之间关联的研究并不多。在本研究中,作者想要明确在印度安得拉邦人群中,发育不全的A1段大脑前动脉与CIS患者预后之间的关系。对2015年至2017年前瞻性确定的201例成年CIS患者进行回顾性分析。对接受3.0T颅内磁共振血管造影的患者,比较了A1段大脑前动脉发育不全的男性和女性病例在临床和影像学方面的差异,以及Willis环的相关变异情况。使用Windows版SPSS 16.0软件对获得的数据进行统计学分析,P值<0.05被认为具有统计学意义。应用卡方检验来确定性别与A1段大脑前动脉发育不全发生率之间的关联。记录了201例A1段大脑前动脉发育不全患者中的64例,无发育不全病例。发现男性多于女性,右侧比左侧更常见。记录到常见的神经症状,如头痛、头晕、视觉不稳定、恶心、肢体无力和癫痫发作,大多数病例与CIS有关。发育不全的A1段大脑前动脉常与同侧大脑前动脉终末支缺血相关,其血流受到对侧大脑前动脉的影响。在本研究中,虽然CIS与发育不全的A1段大脑前动脉没有直接关系,但A1段的任何改变都是卒中的一个重要危险因素。