Posterior communicating artery hypoplasia as a risk factor for acute ischemic stroke in the absence of carotid artery occlusion

Chuang, Yu Ming; Liu, Chih Yang; Pan, Po‐Jung; Lin, Ching Po

doi:10.1016/j.jocn.2008.02.002

Cited by 62 publications

(61 citation statements)

References 18 publications

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“…Since no differences were revealed between the groups of complete and incomplete CoW regarding the LA confounders, such as mean age, gender ratio, hypertension, diabetes mellitus, hypercholesterolemia, and coronary artery disease [1,2,3] (table 1), we believe that CoW anatomy is an independent contributor to LA in case of carotid artery stenosis [13,14,15,16]. …”

Section: Discussionmentioning

confidence: 99%

Associations between Circle of Willis Morphology and White Matter Lesion Load in Subjects with Carotid Artery Stenosis

et al. 2011

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Background: Various cerebral pathological changes have been reported to cause leukoaraiosis (LA). We hypothesized that circle of Willis (CoW) anomalies may contribute to LA in severe carotid artery stenosis victims through impaired cerebral autoregulation. We conducted a retrospective review on cerebral magnetic resonance (MR) patterns in patients with severe symptomatic carotid artery stenosis and compared white matter lesion (WML) load between subjects with and without complete CoW. Methods: LA on fluid attenuation inversion recovery (FLAIR) MR images at the levels of the centrum semiovale and frontal horns in both cerebral hemispheres were scored in 106 patients with unilateral carotid artery stenosis (64 men and 42 women; mean age 68.7 ± 9.2 years, range 44–82). Subjects were divided into groups of complete and incomplete CoW according to cerebral MR angiography. Differences in the LA scores between the groups of complete and incomplete CoW were further analyzed. Results: Compared with those with incomplete configuration of the CoW, subjects with a complete CoW demonstrated a decreased WML load at the level of the centrum semiovale (2.78 ± 1.17 vs. 5.62 ± 2.12, p = 0.02) and frontal horns (2.21 ± 0.79 vs. 4.22 ± 1.83, p = 0.01). Conclusion: Our results support the importance of a complete CoW since it may protect from WML in case of carotid stenosis.

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Section: Discussionmentioning

confidence: 99%

Associations between Circle of Willis Morphology and White Matter Lesion Load in Subjects with Carotid Artery Stenosis

et al. 2011

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“…The number of perforators is variable, between 4 and 14 [3,14,15]. The area supplied by them contains: the premammillary part of III ventricle floor, posterior perforated substance, thalamus, hypothalamus, subthalamus, internal capsule, mammilary bodies, tuber cinereum, optic tract, pituitary stalk, and cerebral peduncle [2,6,12,14].…”

Section: Discussionmentioning

confidence: 99%

“…In the subgroup with PCoA hypoplasia, the variation was higher on the right side but without any significant statistical differences. Chuang et al [2], who studied 310 subjects with hemispheric and brainstem/cerebellum ischaemic stroke conformed by MRI, noted an opposite result. The incidence of hypoplasia was 19.35% with the evident predominance of the left side (63.33%) ( Table 1).…”

Section: Hypoplasiamentioning

confidence: 98%

“…The introduction of the uniformly quantitative criterions on the estimation could be helpful in resolving this problem. During studies of cerebral ischaemic strokes, some patients were found to have PCoAs with a small diameter (less than 1 mm) which could be a risk factor for ischaemic stroke in cases of the ipsilateral ICA occlusion [2,9,13]. Probably, this is why the borderline size of 1 mm is used to describe the PCoA hypoplasia.…”

Section: Hypoplasiamentioning

confidence: 99%

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The posterior communicating artery: morphometric study in 3D angio-computed tomography reconstruction. The proof of the mathematical definition of the hypoplasia

et al. 2014

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“…Researchers have established that if there is an insufficient collateral blood flow made available by the Circle of Willis there is more probability of a stroke if the stream is rerouted to one area, then other areas may have to endure with less flow resulting in hypo perfusion and eventually ischemia. This 'steal phenomenon' is common in the cerebral circulation [19,20].…”

Section: Clinical Significancementioning

confidence: 99%

Study of Variant Posterior Cerebral Circulation and its Clinical Relevance

Sp¹,

Rizvi²

2017

Anat Physiol

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The cerebral blood flow is divided into an anterior circulation and a posterior circulation connected to each other in the form of a circle called Circle of Willis (CW). It is formed by the unification of the internal carotid (ICA) and vertebrobasilar systems Posteriorly, the basilar artery, formed by the left and right vertebral arteries, branches into a left and right posterior cerebral artery (PCA), forming the posterior circulation. The internal carotid system lies anteriorly and is joined to the posterior circulation by posterior communicating (PCoA) arteries. The internal carotid artery divides into anterior and middle cerebral artery. The two anterior cerebral arteries are joined to each other by an anterior communicating artery. The posterior cerebral artery before it joins the posterior communicating artery that means its proximal part is named as the pre communicating part (P1) and the distal part as the post communicating part (P2). In the adult P1 has a diameter larger than the PCoA so that the occipital lobe gets its blood supply mainly via the vertebrobasilar system whereas in the fetus the diameter of the ipsilateral precommunicating (P1) segment of PCA is less than the diameter of PCoA, so that the blood supply to [1] the occipital lobe is mainly via the internal carotid arteries. In some persons, there is a transitional configuration in which the PCoA is equal in diameter to the P1 segment of the PCA. These variations can cause complications if thrombotic material present in atherosclerotic plaques of ICA gets dislodged into PCA through a PCoA which has a larger diameter.In the present study, the configuration of posterior cerebral circulation and its clinical relevance was studied in 40 human brains in the department of anatomy at KJSMC. Adult Type PCA was found in 60% of the specimens studied, Fetal Type PCA was found in 12.5% of the specimens, Transitional Type PCA was found in 25% of the specimens and a combination of Adult and Transitional Type was found in 2.5% of the specimens.

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Posterior communicating artery hypoplasia as a risk factor for acute ischemic stroke in the absence of carotid artery occlusion

Cited by 62 publications

References 18 publications

Associations between Circle of Willis Morphology and White Matter Lesion Load in Subjects with Carotid Artery Stenosis

Associations between Circle of Willis Morphology and White Matter Lesion Load in Subjects with Carotid Artery Stenosis

The posterior communicating artery: morphometric study in 3D angio-computed tomography reconstruction. The proof of the mathematical definition of the hypoplasia

Study of Variant Posterior Cerebral Circulation and its Clinical Relevance

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