Configuration of Circle of Willis and Its Clinical Significance

Authors

  • Aisha Hassan Brohi
  • Kevin Joseph Jerome Borges
  • Gulraiz Hikmat Yar
  • Syed Nudrat Nawaid Shah
  • Nuzhat Hassan

DOI:

https://doi.org/10.51985/JBUMDC2018078

Keywords:

Circle of Willis, Anatomical variations, cerebral arteries

Abstract

In occlusive vascular brain diseases, the structure of the circle of Willis is of immense importance. A high percentage of
variations have been reported in the arteries forming circle of Willis. These have profound clinical implications. With
advances in interventional radiological procedures, the interventional radiologists and neurosurgeons need to have thorough
knowledge of these variations. This article will help readers understand the significance of anatomical variations and their
clinical effects.

References

Siddiqi H, Tahir M, Lone KP. Variations in cerebral arterial

circle of Willis in adult Pakistani population. J Coll Physicians

Surg Pak. 2013;23(9):615-9.

Varga A, Di Leo G, Banga PV, Csobay-Novák C, Kolossváry

M, Maurovich-Horvat P, et al. Multidetector CT angiography

of the Circle of Willis: association of its variants with carotid

artery disease and brain ischemia. European Radiology.

:1-11.

Poudel P, Bhattarai C. Anomalous formation of the circulus

arteriosus and its clinico-anatomical significance. Nepal Med

Coll J. 2010;12(2):72-5.

Moore KL, Dalley AF, Agur AM. Clinically oriented anatomy:

Lippincott Williams & Wilkins; 2013.

Sharada H. Morphometric Analysis and Variations of the

Circle of Willis.

Hamidi C, Bükte Y, Hattapoðlu S, Ekici F, Tekbaº G, Önder

H, et al. Display with 64-detector MDCT angiography of

cerebral vascular variations. Surgical and Radiologic Anatomy.

;35(8):729-36.

Snell RS. Clinical neuroanatomy: Lippincott Williams &

Wilkins; 2010.

Snell RS. Clinical anatomy by systems: Lippincott Williams

& Wilkins; 2007.

Veeramani R, Holla SJ, Chand P, Chumber S. First South

Asia Edition-Grays Anatomy For Students_Ebook: Elsevier

Health Sciences; 2017.

Drake R, Vogl AW, Mitchell AW. Gray's Anatomy for Students

E-Book: Elsevier Health Sciences; 2009.

Sawanth S, Rizvi S. Study of Variant Posterior Cerebral

Circulation and its Clinical Relevance. Anat Physiol.

;7(264):2161-0940.1000264.

De Silva KRD, Silva R, Amaratunga D, Gunasekera W,

Jayesekera RW. Types of the cerebral arterial circle (circle of

Willis) in a Sri Lankan population. BMC neurology.

;11(1):5.

Saikia B, Handique A, Phukan P, Lynser D, Sarma A. Circle

of Willis: Variant forms and their embryology using gross

dissection and Magnetic Resonance Angiography. Int J Anat

Res. 2014;2(2):344-53.

Moore KL, Persaud TVN, Torchia MG. The Developing

Human E-Book: Elsevier Health Sciences; 2011.

Menshawi K, Mohr JP, Gutierrez J. A functional perspective

on the embryology and anatomy of the cerebral blood supply.

Journal of stroke. 2015;17(2):144.

Hakim A, Gralla J, Rozeik C, Mordasini P, Leidolt L,

Piechowiak E, et al. Anomalies and Normal Variants of the

Cerebral Arterial Supply: A Comprehensive Pictorial Review

with a Proposed Workflow for Classification and Significance.

Journal of neuroimaging. 2018;28(1):14-35.

Nordon D, Rodrigues Junior O. Variations in the brain

circulation–the circle of Willis. J Morphol Sci. 2012;29(4):243-

Saikia B, Handique A, Phukan P, Lynser D, Jamil M. Study

of anomalies in the circle of Willis using magnetic resonance

angiography in north eastern India. Journal of the Anatomical

Society of India. 2014;63(1):67-73.

KARATAS¹ A, Yilmaz H, Coban G, Koker M, Uz A. The

anatomy of circulus arteriosus cerebri (circle of Willis): a

study in Turkish population. Turk Neurosurg. 2016;26(1):54-

Zhu G, Yuan Q, Yang J, Yeo JH. The role of the circle of

Willis in internal carotid artery stenosis and anatomical variations: a computational study based on a patient-specific

three-dimensional model. Biomedical engineering online.

;14(1):107.

Chuang Y-M, Chan L, Lai Y-J, Kuo K-H, Chiou Y-H, Huang

L-W, et al. Configuration of the circle of Willis is associated

with less symptomatic intracerebral hemorrhage in ischemic

stroke patients treated with intravenous thrombolysis. Journal

of critical care. 2013;28(2):166-72.

Hendrikse J, Hartkamp MJ, Hillen B, Mali WP, van der Grond

J. Collateral ability of the circle of Willis in patients with

unilateral internal carotid artery occlusion: border zone infarcts

and clinical symptoms. Stroke. 2001;32(12):2768-73.

Chuang Y-M, Liu C-Y, Pan P-J, Lin C-P. Posterior

communicating artery hypoplasia as a risk factor for acute

ischemic stroke in the absence of carotid artery occlusion.

Journal of Clinical Neuroscience. 2008;15(12):1376-81.

Goerlitz J, Wenz H, Al-Zghloul M, Kerl HU, Groden C,

Förster A. Anatomical variations in the posterior circle of

Willis and vascular pathologies in isolated unilateral thalamic

infarction. Journal of neuroimaging. 2015;25(6):983-8.

Yamaguchi K, Uchino A, Sawada A, Takase Y, Kuroda Y,

Kudo S. Bilateral anterior cerebral artery territory infarction

associated with unilateral hypoplasia of the A1 segment:

report of two cases. Radiation medicine. 2004;22(6):422-5.

Miyazawa N, Shinohara T, Yamagata Z. Association of

incompleteness of the anterior part of the circle of Willis with

the occurrence of lacunes in the basal ganglia. European

journal of neurology. 2011;18(11):1358-60.

Iqbal S. A comprehensive study of the anatomical variations

of the circle of willis in adult human brains. Journal of clinical

and diagnostic research: JCDR. 2013;7(11):2423.

Gunnal S, Farooqui M, Wabale R. Anatomical variations of

the circulus arteriosus in cadaveric human brains. Neurology

research international. 2014;2014.

Zhou H, Sun J, Ji X, Lin J, Tang S, Zeng J, et al. Correlation

between the integrity of the circle of Willis and the severity

of initial noncardiac cerebral infarction and clinical prognosis.

Medicine. 2016;95(10).

Van Ooij P, Zwanenburg J, Visser F, Majoie C, Vanbavel E,

Hendrikse J, et al. Quantification and visualization of flow

in the Circle of Willis: Time-resolved three-dimensional phase

contrast MRI at 7 T compared with 3 T. Magnetic resonance

in medicine. 2013;69(3):868-76.

Crompton M. The pathology of ruptured middle-cerebral

aneurysms with special reference to the differences between

the sexes. Lancet. 1962;2:421-5.

Klimek-Piotrowska W, Kopeæ M, Kochana M, Krzy¿ewski

R, Tomaszewski K, Brzegowy P, et al. Configurations of the

circle of Willis: a computed tomography angiography based

study on a Polish population. Folia morphologica.

;72(4):293-9.

Maaly MA, Ismail AA. Three dimensional magnetic resonance

angiography of the circle of Willis: anatomical variations in

general Egyptian population. The Egyptian Journal of

Radiology and Nuclear Medicine. 2011;42(3-4):405-12.

Kumar APV, Prasad K. A Study of Variation of Circle of

Willis, in the Adult Population of South India. International

Journal of Contemporary Medical Research.

Kondori BJ, Azemati F, Dadseresht S. Magnetic Resonance

Angiographic Study of Anatomic Variations of the Circle of

Willis in a Population in Tehran. Archives of Iranian medicine.

;20(4).

Sande V, Wanjari S. Variations in the Arterial Circle of Willis

in Cadaver: A Dissection Study. International Journal of Health

Sciences and Research (IJHSR). 2014;4(8):132-8.

Dimmick SJ, Faulder KC. Normal variants of the cerebral

circulation at multidetector CT angiography. Radiographics.

;29(4):1027-43.

de Rooij NK, Velthuis BK, Algra A, Rinkel GJ. Configuration

of the circle of Willis, direction of flow, and shape of the

aneurysm as risk factors for rupture of intracranial aneurysms.

Journal of neurology. 2009;256(1):45.

Zhang C, Wang L, Li X, Li S, Pu F, Fan Y, et al. Modeling

the circle of Willis to assess the effect of anatomical variations

on the development of unilateral internal carotid artery stenosis.

Bio-medical materials and engineering. 2014;24(1):491-9.

Bor ASE, Velthuis BK, Majoie CB, Rinkel GJ. Configuration

of intracranial arteries and development of aneurysms A

follow-up study. Neurology. 2008;70(9):700-5.

Klimek-Piotrowska W, Rybicka M, Wojnarska A, Wójtowicz

A, Koziej M, Ho³da MK. A multitude of variations in the

configuration of the circle of Willis: an autopsy study.

Anatomical science international. 2016;91(4):325-33

Downloads

Published

2018-10-01

How to Cite

Aisha Hassan Brohi, Kevin Joseph Jerome Borges, Gulraiz Hikmat Yar, Syed Nudrat Nawaid Shah, & Hassan, N. . (2018). Configuration of Circle of Willis and Its Clinical Significance. Journal of Bahria University Medical and Dental College, 8(4), 270–273. https://doi.org/10.51985/JBUMDC2018078

Issue

Section

Review Article