Anatomical variations in the posterior portion of the circle of Willis

Authors

  • Raiza Luna Peixoto Estudante de medicina na Universidade Federal da Paraíba
  • Débora de Araujo Paz Estudante de medicina na Universidade Federal da Paraíba
  • João Luiz de Oliveira Gadelha Dantas Estudante de medicina na Universidade Federal da Paraíba
  • Maurus Marques de Almeida Holanda Professor Doutor de Neurologia da Universidade Federal da Paraíba

DOI:

https://doi.org/10.15448/1983-652X.2015.1.17217

Keywords:

Circle of Willis. Anatomic variation. Basilar artery.

Abstract

Introduction: The brain is vascularized by the internal carotid and vertebral arteries, which form, at the base of the skull, an anastomotic polygon, the cerebral arterial circle (CAC), also known as the circle of Willis. The anatomical variation in the CAC is frequent, many of them being correlated to the occurrence of cerebrovascular diseases.
Objectives: This study aimed at identifying the prevalence of anatomical variations of the arteries of the posterior portion of the CAC based on data obtained from autopsies of cadavers of the Serviço de Verificação de Óbitos, located at Federal University of Paraiba.
Materials and Methods: 30 human cerebral hemispheres of both sexes between 18 and 70 years of age were dissected. Next, the vertebrobasilar and the internal carotid circulation were studied.
Results: There was a rate of 60% of abnormalities in the anatomic posterior cerebral circulation. The cerebral hemisphere more affected was the right one. Anatomical variations were more prevalent in the posterior communicating artery, and the type of anatomical variation that occurred most frequently was hypoplasia.
Conclusion: Knowing the peculiarities of the anatomical variations of CAC is fundamental, due to its high prevalence and its essentiality to understand the emergence of cerebrovascular diseases, such as aneurysms, to perform microvascular reconstructive procedures, as well as to provide essential information on radiological examinations.

References

Machado A. Neuroanatomia funcional. 2ª ed. São Paulo: Atheneu; 2006.

Cecil L. Textbook of Medicine. 20th ed. Philadelphia: W. B Company; 2005.

Henderson RD, Eliasziw M, Fox AJ, et al. Angiographically defined collateral circulation and risk of stroke in patients with severe carotid artery stenosis. Stroke. 2000; 31:128–132.

Horikoshi T, Akiyama I, Yamagata Z, et al. Magnetic resonance angiographic evidence of sex-linked variations in the circle of willis and the occurrence of cerebral aneurysms. J Neurosurg. 2002; 96:697–703.

Eftekhar B, Dadmehr M, Ansari S, et al. Are the distributions of variations of circle of Willis different in different populations? - Results of an anatomical study and review of literature. BMC Neurology. 2006; 6: 1-9.

Miyazaki S, Kamata K, Yamaura A, et al. Multiple aneurysms of the vertebrobasilar system associated with fenestration of the vertebral artery. Surg Neurol. 1981; 15(3): 192-195.

Mazighi M, Porter PJ, Rodesch G, et al. Vascular anomalies and the risk of multiple aneurysms development and bleeding. Interventional Neuroradiology. 2002; 8(1):15-20.

Krishnamurthy A, Rao CP, Narayana K et al. Circulus arteriosus cerebri: a study of variation in the fetal and adult human brains of south Indians. Morphologie. 2006; 90(290): 139-43.

Soares JC, Tamega OJ, Schwerdtfeger W et al. Estudo anatômico e morfométrico dos vasos que constituem o Polígono de Willis. Rev. bras. ciênc. morfol. Jul-dez 1994; 11(2): 115-24.

Bisaria KK. Anomalies of the posterior communicating artery and their potential clinical significance. Journal of Neurosurgery .1984; 60: 572-675.

Shomer DF, Marks MP, Steinberg G et al. The anatomy of the posterior communicating artery as a risk factor for ischemic cerebral infarction. N Engl J Med.1994; 330: 1565-70.

Şengül G , Akar A, Aydin IH . Intraoperative Observations of Anatomic Variations of the Posterior Communicating Artery: a Microsurgical Approach. J Neurol Sci. 2009; 26:279-285

De Silva KR, Silva R, Amaratunga D, Gunasekera WS, Jayesekera RW. Types of the cerebral arterial circle (circle of Willis) in a Sri Lankan population. BMC Neurol. 2011 Jan 17;11:5.

Merkkola P, Tulla H, Ronkainen A, Soppi V, Oksala A, Koivisto T, Hippelainen M. Incomplete circle of Willis and right axillary artery perfusion. Ann Thorac Surg. 2006; 82: 74–79

Caruso G; Vincentelli, F; Rabehanta, P; Giudicelli G; Grisoli, F. Anomalies of the P1 segment of the posterior cerebral artery: early bifurcation or duplication, fenestration, common trunk with the superior cerebellar artery. Acta Neurochir (Wien). 1991; 109: 66–71

Kapoor K, Singh B, Dewan LI. Variations in the configuration of the circle of Willis. Anat Sci Int. 2008; 83: 96–106.

Published

2015-06-08

Issue

Section

Original Articles