Anatomic imaging study of luminal diameter of the circle of Willis in patients with ischemic stroke

Abstract

Objectives: Stroke or cerebrovascular accident is associated with defects in the circle of Willis; the vascular network that supplies the brain. There is currently lack of literature on the involvement of the circle of Willis in patients with stroke or its association with impending stroke. The objective of the study was to evaluate luminal diameter of arteries that constitute the circle of Willis in patients with stroke using computed tomography angiography (CTA) and magnetic resonance imaging (MRI) scans. Material and Methods: Angiograms of 340 male and female patients aged 15–>75 (40.18 ± 1.1 and 43.68 ± 1.18) years with suspected stroke, referred for either brain CTA or MRI in selected hospitals/diagnostic centers in Nigeria were evaluated using RadiAnt and the MicroDicom viewer software applications. A retrospective descriptive research design was adopted with approval from the federal health research ethics committee. Direct measurement of luminal diameter of major arteries of the circle of Willis was done using SPSS version 25 at P < 0.05. Results: From the 340 images assessed, 256 (75.29%) patients had ischemic stroke with luminal diameter of arteries of the circle of Willis ranged from 1 mm to >3 mm while 84 (24.71%) patients were without stroke with luminal diameter ranged from 1 mm to 2.11 mm (P < 0.05). Conclusion: Patients with stroke have larger luminal diameter of arteries that form the circle of Willis when compared to patients without stroke. The study has established for the 1st time, luminal diameter of circle of Willis that may be an index in the sampled Nigerian population.

Morphological patterns of the cerebral arterial circle of Willis: Implication in subjects with ischemic stroke

“…[1][2][3][4][5][6][7][8][9] Studies have demonstrated a classical and complete pattern of a circle of Willis where all the vessels are intact and crucial for a continuous supply of blood. 6,8,[10][11][12][13][14][15] or the duration and extent of obstruction needs to be answered. To address these deficiencies, it is important to investigate how morphological patterns of the circle of Willis influence stroke development using CTA and MRI as diagnostic tools.…”

Nonenhanced Computed Tomography Evaluation Of Ischemic Stroke Patients Presenting After 4.5 Hours From Onset Of Symptoms Using Aspects, Posterior Circulation-Aspects And X-Ray Attenuation Ratio: The “Tissue Window”

“…These innovative quantitative assessments of acute ischemic stroke with nonenhanced computed tomography are poorly utilized in most Nigerian hospitals. Subsequently, 90.9 -100% of ischemic stroke patients do not receive the appropriate treatment with resultant high rate of mortality and disability where majority of the patients become vulnerable to having secondary complications of the disease (stroke) including lobar atrophy, white matter lesions, cerebral infarct, in addition to structural changes/morphological patterns in the circle of Willis: the major arterial supply to the brain (Igiri et al, 2017;Paulinus et al, 2017;Udo-Affah et al, 2020;Paulinus et al, 2021;Paulinus et al, 2023). The study therefore, focused on patients who presented late (4.5 to 24 hours) for nonenhanced CT, were eligible for treatment with intravenous thrombolysis or endovascular thrombectomy based on ASPECTS, pc-ASPECTS and Hounsfield unit (HU) ratio.…”