Clinic of Neurosurgery, Clinical Center Niš, Zorana Đinđića 48, 18000 Niš, Serbia.
Faculty of Medicine, University of Niš, Zorana Đinđića 81,18000 Niš, Serbia.
Medicina (Kaunas). 2019 Jul 3;55(7):338. doi: 10.3390/medicina55070338.
: Intracranial hemorrhage caused by the rupture of brain aneurysms occurs in almost 10 per 100,000 people whereas the incidence of such aneurysms is significantly higher, accounting for 4-9%.Linking certain factors to cerebral aneurysm rupture could help in explaining the significantly lower incidence of their rupture compared to their presence. The aim of this study is to determine the association between the corresponding circle of Willis configurations and rupture of cerebral aneurysms.
A group of 114 patients treated operatively for aruptured cerebral aneurysm and a group of 56 autopsied subjects were involved in the study. Four basic types of the circle of Willis configurations were formed-two symmetric types A and C, and two asymmetric types B and D.
A statistically significantly higher presence of asymmetry of the circle of Willis was determined in the group of surgically-treated subjects (p = 0.001),witha significant presence of asymmetric Type B in this group (p < 0.001). The changeson the A1 segment in the group of surgically-treated subjects showed a statistically significant presence compared to the group of autopsied subjects (p = 0.001). Analyzing the presence of symmetry of the circle of Willis between the two groups, that is, the total presence of symmetric types A and C, indicated their statistically significant presence in the group of autopsied patients (p < 0.001).
Changes such as hypoplasia or aplasia of A1 and the resulting asymmetry of the circle of Willis directly affect the possibility of the rupture of cerebral aneurysms. Detection of the corresponding types of the circle of Willis after diagnostic examination can be the basis for the development of a protocol for monitoring such patients.
颅内出血由脑动脉瘤破裂引起，每 10 万人中约有近 10 人发生，而此类动脉瘤的发病率明显更高，为 4-9%。将某些因素与脑动脉瘤破裂联系起来，可以帮助解释其破裂率明显低于存在率的原因。本研究旨在确定相应的 Willis 环构型与脑动脉瘤破裂之间的关系。
研究纳入了 114 例接受手术治疗的破裂脑动脉瘤患者和 56 例尸检患者。Willis 环的基本构型有 4 种，包括两种对称构型 A 和 C，以及两种不对称构型 B 和 D。
手术治疗组的 Willis 环不对称性明显更高（p=0.001），其中 B 型不对称性更为明显（p<0.001）。手术治疗组的 A1 段变化与尸检组相比具有统计学意义（p=0.001）。分析两组 Willis 环对称性的存在情况，即 A 和 C 两种对称类型的总存在情况，表明尸检组的存在情况具有统计学意义（p<0.001）。
A1 段发育不良或缺失等变化以及由此导致的 Willis 环不对称性直接影响脑动脉瘤破裂的可能性。诊断检查后检测相应的 Willis 环类型可以为制定此类患者的监测方案提供依据。
