Analysis of the symmetric configuration of the circle of Willis in a series of autopsied corpses
Introduction. The forming of the blood vessels network configuration at the base of the brain and interconnecting of blood vessels during the embryogenesis is directly related to the phylogenetic development of the brain and brain structures. A blood vessel configuration at the brain base,...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2015-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501504356S.pdf |
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| Summary: | Introduction. The forming of the blood vessels network configuration at the
base of the brain and interconnecting of blood vessels during the
embryogenesis is directly related to the phylogenetic development of the
brain and brain structures. A blood vessel configuration at the brain base,
in the form of a ring or a hexagon, stands in direct relation to the
perfusion needs of certain parts of the brain during its primary
differentiation. The aim of this paper was to determine the incidence of
certain blood vessel configurations at the base of the brain and
understanding their symmetry or asymmetry. Methods. Analysis of the blood
vessels at the base of the brain was performed on the autopsied subjects.
The object of observation was the anterior segment of the circle of Willis
consisting of C1- a. carotis interna (ICA), above a. communicaus posterior
(PcoA), the segment A1 a. cerebri anterior (ACA) from a. carotis interna
bifurcation to the a. communicans anterior (AcoA) and a. communicans
anterior itself, as well as the posterior segment consisting of PcoA and the
segment P1 - a. cerebri posterior (PCA) from the a. basilaris bifurcation to
the PcoA. For the purpose of grouping the findings, the four basic
configuration types of the circle of Willis were identified based on its
symmetry or asymmetry. Type-A (symmetric circle of Willis), type-B
(asymmetric circle of Willis' due to the unilateral hypoplastic A1-ACA);
type-C (symmetric circle of Willis with bilateral symmetric changes on PcoA)
and type-D (asymmetric circle of Willis due to the asymmetric changes on
PcoA). Results. Autopsy was performed on 56 corpses. A total of 41 (73.2%)
subjects were recorded with a symmetric configuration of the circle of
Willis', of which 27 (48.2%) subjects had type A and 14 (25%) type C. The
asymmetric configuration was present in 15 (26.8%) subjects, of whom 9 (16%)
had type B and 6 (10.8%) type D. The symmetric Willis group (73.2%) did not
have a homogeneous finding that would fit into the schematic presentation of
the symmetric type A and type C. A total of 17 (30.4%) findings were
classified in this group of the so-called conditionally symmetric
configurations. In all the cases, type B (16%) had unilaterally reduced
diameter A1 and hyperplastic AcoA. Conclusion. The presence of asymmetric
Willis configuration in 26.8% of the cases, which makes up more than one
fourth, indicates that the asymmetric configurations do not represent a
pathological form of connecting the blood vessels at the base of the brain,
but rather one aspect of its adaptation. The forming of the basic types of
configurations of the circle of Willis is associated with a tendency toward
certain types of hemodynamic disorders and more frequent pathological
changes in places of reduced resistance. |
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| ISSN: | 0042-8450 |