Revista de Morfología y Anatomía

Anatomical Variants of the Posterior Part of the Circle of Willis in Patients with Cerebrovascular Diseases

Abstract

Ana-Maria Dumitrescu1, Claudia Florida Costea2*, Roxana Gabriela Cobzaru3, Carmen Valentina Rîpa3, Cringuta Paraschiv4, Irina LucianaGurzu5 ,Andrei Ionut Cucu6, Serban Turliuc7, Egidia Gabriela Miftode8, Raluca Alina Dragomir9 and Anca Sava1,10

Introduction: The current literature proves that the frequency of anatomical variants of circle of Willis (CoW) has not yet been sufficiently evaluated both in the Romanian population and internationally, and in the North East region of Romania there is no evidence of such research so far. The aim of this study is to identify the frequency and types of anatomical variants of the constituent arteries of the posterior part of the CoW in patients with cerebrovascular diseases diagnosed within the main Neurology hospital in the Northeastern region of Romania, based on macroscopic analysis of arterial specimens obtained at autopsy and to compare the results with data from updated literature.

Material and Methods: Our research represents a descriptive observational study, conducted retrospectively on 96 patients with cerebrovascular diseases who died over a period of 30 months and underwent an anatomo-clinical autopsy. We analysed the general macroscopic aspects of all anatomical variants of the constituent arteries of the posterior part of the CoW, comparing these to the opposite arteries.

Result: Out of the total of 96 available human brains, 28 cases (29.17%) presented anatomical variants of CoW, among which 11 cases (39.28%) presented at least one anatomical variant of the constitutive arteries of its posterior part. The average age of these patients was 59.18 years. 36.36% cases had a single anatomical variant, 54.54% cases had two anatomical variants, and 9.09% all of cases associated an anatomical variant of the posterior part of CoW and one of the vertebral arteries. Anatomical variations of the arteries of the posterior part of the CoW were observed in 14 arteries (31.81%) of all the 44 available, and consisted in unilateral or bilateral hypoplasia (20.45%) or absence (15.90%), located either on the right or on the left, and partial fetal posterior communicating artery (2.27%) located on the left side. We identified seven morphological patterns of the posterior part of CoW in the conditions in which its anterior part does not present any anatomical variants.

Conclusion: The data obtained in the present research allow us to affirm that circle of Willis represents an anatomical structure with a great morphological diversity of its posterior part. This study contributes to the knowledge of this topic in Romania and allows comparisons with data obtained both in the country and abroad.