Eftekhari Moghadam Ali Reza, Absalan Forouzan, Khatavian Ehsan, Jalilian Milad, Maghsoudi Fatemeh
Department of Anatomical Science, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Medical Faculty, Abadan University of Medical Sciences, Abadan, Iran.
Adv Biomed Res. 2024 Nov 30;13:109. doi: 10.4103/abr.abr_273_23. eCollection 2024.
The Circle of Willis (CoW) forms a critical collateral route for the compensation pathway at the basal cistern of the brain. This study aims to determine if migraine headaches and cerebrovascular accidents (CVAs) are associated with the prevalence and patterns of CoW arterial variations seen in the three-dimensional time-of-flight magnetic resonance angiography technique in patients.
A cross-sectional study was undertaken by a systemic search of electronic databases in the Imaging Center, Abadan's Taleghani Hospital, Iran, from March 2020 to March 2022. Data on the prevalence of variations in patients who presented for screening for migraine and CVA were extracted and analyzed with Student -test and the Chi-square method.
Findings show complete CoW has been visible in 20.19% of our patients. The anterior part of the CoW was almost intact in all patients. The posterior part of CoW was mostly bilaterally hypoplastic (31.73%) or bilateral aplastic (29.81%) and in some rare cases unilaterally varied. In migraine patients, CoW was rarely in its classic form (15%) and was varied bilaterally in 72.5% of the cases. In CVA patients, CoW was in its complete vascular structure in 23.08% and bilaterally varied in 46.15% of all cases.
Overall, migraine and CVA are associated with anatomical variations in the posterior portions of the CoW. Further larger prospective trials are needed to determine the true prevalence of CoW variations and their pathological significance.
Willis 环(CoW)是脑基底池代偿通路的关键侧支循环途径。本研究旨在确定偏头痛和脑血管意外(CVA)是否与患者三维时间飞跃磁共振血管造影技术中所见的CoW动脉变异的患病率及模式相关。
2020年3月至2022年3月,在伊朗阿巴丹的 Taleghani 医院影像中心对电子数据库进行系统检索,开展了一项横断面研究。提取并分析偏头痛和CVA筛查患者的变异患病率数据,采用 Student 检验和卡方检验。
结果显示,20.19%的患者可见完整的CoW。所有患者的CoW前部几乎完整。CoW后部大多为双侧发育不全(31.73%)或双侧未发育(29.81%),在一些罕见情况下为单侧变异。在偏头痛患者中,CoW很少呈经典形式(15%),72.5%的病例为双侧变异。在CVA患者中,23.08%的患者CoW具有完整的血管结构,46.15%的病例为双侧变异。
总体而言,偏头痛和CVA与CoW后部的解剖变异有关。需要进一步开展更大规模的前瞻性试验,以确定CoW变异的真实患病率及其病理意义。