Circle of Willis variations in migraine patients with ischemic stroke

Abstract

Objectives Migraine is a risk factor for stroke, which might be explained by a higher prevalence in anatomical variants in the circle of Willis (CoW). Here, we compared the presence of CoW variants in patients with stroke with and without migraine. Materials and Methods Participants were recruited from the prospective Dutch acute Stroke Study. All participants underwent CT angiography on admission. Lifetime migraine history was assessed with a screening questionnaire and confirmed by an interview based on International Classification of Headache Disorders criteria. The CoW was assessed for incompleteness/hypoplasia (any segment <1 mm), for anterior cerebral artery asymmetry (difference > 1/3), and for posterior communicating artery (Pcom) dominance (Pcom–P1 difference > 1/3). Odds ratios with adjustments for age and sex ( aOR ) were calculated with logistic regression. Results We included 646 participants with stroke, of whom 52 had a history of migraine. Of these, 45 (87%) had an incomplete or hypoplastic CoW versus 506 (85%) of the 594 participants without migraine ( aOR : 1.47; 95% CI : 0.63–3.44). There were no differences between participants with and without migraine in variations of the anterior or posterior CoW, anterior cerebral artery asymmetry ( aOR : 0.86; 95% CI : 0.43–1.74), or Pcom dominance ( aOR : 0.64; 95% CI : 0.32–1.30). There were no differences in CoW variations between migraine patients with or without aura. Conclusion We found no significant difference in the completeness of the CoW in acute stroke patients with migraine compared to those without.

Circle of Willis variants and their association with outcome in patients with middle cerebral artery‐M1‐occlusion stroke

“…Due to the small size of CoW segments, the true number of patients with a complete CoW might be higher. Nevertheless, the amount of different CoW variants we found was in accordance with other studies using different methods [ 9 , 10 ]. Furthermore, the restriction to an LVO stroke cohort might have influenced or overlapped the effect of CoW variants on outcome.…”

“…This led to the development of four vascular models of presumed flow compensation in cases of MCA‐M1‐occlusion stroke (Figure 1 ) according to previously described flow dynamics in patients with LVO [ 5 , 6 , 7 ]. We found that a high (82.4%) proportion of patients with MCA‐M1‐occlusion stroke had an incomplete or hypoplastic CoW affecting predominantly the posterior circulation (77.2%), which is in line with previous data [ 10 ].…”

The Association between Migraine and Fetal-Type Posterior Cerebral Artery in Patients with Ischemic Stroke

“…Another [20] showed a significantly higher proportion of complete fetal-type PCA in migraineurs without aura. Only one previous study [21] investigated circle of Willis variations and migraine in stroke populations, which had a similar design to ours but negative results. First, this inconsistency might be interpreted by differences in criteria assessing the fetal-type PCA.…”

A Correlação Entre Malformações De Artérias Comunicantes Posteriores Com Paralisia De Nervo Oculomotor E Aneurismas

“…De qualquer maneira, evidenciase que padrões de fluxo alterados e altas taxas de fluxo colateral são encontrados perto das oclusões em muitos casos de AVE (CHIEN, 2017). Atualmente, problemas relacionados a doenças cerebrovasculares estão aumentando, e o AVE é a quarta principal causa de morte e o evento mais comum de perda de autonomia e qualidade de vida (HAMMING, 2019).…”