Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
Department of Neurosurgery, Inkosi Albert Luthuli Central Hospital, School of Clinical Medicine, College of Health Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Sci Rep. 2024 Mar 13;14(1):6060. doi: 10.1038/s41598-024-56767-y.
The cerebral arteries, specifically the anterior cerebral artery (ACA) and posterior cerebral artery (PCA), work together with the smaller calibre arteries to provide effective communication between the anterior and posterior circuits of the brain via the circle of Willis (CoW). Morphologic variations of the cerebral arteries and the CoW may alter blood flow to the brain, resulting in intracranial vascular disorders associated with stroke, and aneurysms. This study aimed to document the morphology of the cerebral arteries and the CoW in the South African population. Two hundred and thirty-nine computed tomography angiography scans were assessed. Cerebral arteries and CoW normal morphology and variations were classified as complete, absent, or hypoplastic. The ACA A was absent in 4.91%, hypoplastic in 30.40%, fenestrated in 1.06%, and typical in 63.6%. The ACA A was absent in 0.42%, hypoplastic in 26.28%, and typical in 69.44%. We found triple ACA A in 2.98%, azygos in 1.28% and fenestrated in 1.28%. The middle cerebral artery (MCA) was hypoplastic in 7.35% and typical in 92.64%. The PCA was hypoplastic in 28.74% and typical in 71.25%. Knowledge of the configuration of the CoW plays a significant role in guiding therapeutic decision-making in treating various neurovascular pathologies.
大脑动脉，特别是大脑前动脉（ACA）和大脑后动脉（PCA），与更小口径的动脉一起，通过Willis 环（CoW）为大脑的前循环和后循环之间提供有效的沟通。大脑动脉和 CoW 的形态变异可能会改变大脑的血流，导致与中风和动脉瘤相关的颅内血管疾病。本研究旨在记录南非人群的大脑动脉和 CoW 的形态。评估了 239 例计算机断层血管造影扫描。将大脑动脉和 CoW 的正常形态和变异分为完整、缺失或发育不良。ACA A 缺失率为 4.91%，发育不良率为 30.40%，有窗率为 1.06%，典型率为 63.6%。ACA P1 缺失率为 0.42%，发育不良率为 26.28%，典型率为 69.44%。我们发现 2.98%存在三重 ACA A，1.28%存在迷走 ACA A，1.28%存在有窗 ACA A。大脑中动脉（MCA）发育不良率为 7.35%，典型率为 92.64%。PCA 发育不良率为 28.74%，典型率为 71.25%。了解 CoW 的形态对于指导治疗各种神经血管病变的决策具有重要意义。
