Anterior Cerebral Artery A1 Segment Hypoplasia May Contribute to A1 Hypoplasia Syndrome

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

doi:10.1159/000099160

Cited by 51 publications

(58 citation statements)

References 25 publications

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“…Studies have shown that up to 13% of the population may have A1 segment hypoplasia, and this is considered a normal variant. 32 We observed a higher incidence in our patients. Our data support and expand the work of others in identifying risk factors for associations with segmental hemangiomas.…”

Section: Hemangioma Segmental Analysissupporting

confidence: 42%

PHACES Association: A Neuroradiologic Review of 17 Patients

Oza¹,

Wang²,

Berenstein³

et al. 2008

AJNR Am J Neuroradiol

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Section: Hemangioma Segmental Analysissupporting

confidence: 42%

PHACES Association: A Neuroradiologic Review of 17 Patients

Oza¹,

Wang²,

Berenstein³

et al. 2008

AJNR Am J Neuroradiol

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“…In a prior study, it was thought that the hypoplasia of the ACA A1 segment may be a factor that contributes to acute ischemic stroke, due to compromise of the collateral circulation. When compared with healthy individuals, the anomaly was detected significantly more often in acute ischemic stroke patients 11 . In a study conducted by Shaban et al, hypoplastic and absent ACA A1 were detected in 5.9% of acute ischemic stroke patients, although hypoplastic and absent ACA A1 did not have any effect on vascular distribution, side, or the volume of the infarct 10 .…”

Section: Discussionmentioning

confidence: 91%

The association of the circle of Willis anomaly and risk of stroke in patients with carotid artery disease

Göksu

Koç

Kucukseymen

et al. 2017

Arq. Neuro-Psiquiatr.

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Extracranial atherosclerotic disease accounts for 15-20% of all ischemic strokes 1 . In patients with carotid atherosclerosis, the risk of stroke is altered by the presence of collateral circulation and by the varying demographic properties of the patients 2 . The incidence of stroke in patients with asymptomatic and symptomatic internal carotid artery stenosis is 1, 2-5, 9% and 10% respectively 1 . The protective role of collateral circulation depends on many factors such as anatomic variations, systemic arterial pressure, age and the progression rate of the occlusive disease. The mainstay of collateral circulation is the circle of Willis and, in the case of a large artery occlusion, it is readily available to restore the perfusion. The anatomic properties of the collateral circulation may determine the subtypes of stroke in patients with occlusive carotid artery disease. In a previous study, up to 50% of anatomical variations in the cerebral collateral of patients were detected in the circle of Willis 2 . In patients with symptomatic carotid artery stenosis, reduction of blood flow due to a stenotic carotid artery is compensated by the increased blood flow of the collateral system 3 . The circle of Willis is an important collateral pathway, as it can maintain blood flow from the contralateral carotid and basilar artery to the stenotic carotid artery region. In a study of patients with symptomatic carotid artery disease, ABSTRACTThe circle of Willis is an important collateral system that maintains perfusion to the stenotic area from the contralateral carotid and basilar artery to the region of reduced brain perfusion. The aim of the present study was to compare the circle of Willis anomaly in patients with unilateral symptomatic and asymptomatic carotid artery disease. Results: In this retrospective study, we analyzed 175 patients who presented at our outpatient stroke clinic between January, 2013 and June, 2015 with either unilateral symptomatic or asymptomatic carotid artery disease, and who had had CT angiography imaging performed. Demographic properties, carotid artery stenosis and the anomaly of the circle of Willis was recorded. Conclusion: There was no statistically significant difference in patients with symptomatic and asymptomatic carotid artery disease in terms of the anomaly of the circle of Willis.Keywords: circle of Willis; carotid artery diseases; stroke; angiography. RESUMO O Círculo de Willis é um importante sistema colateral que mantém a perfusão à área estenótica da carótida contralateral e da artéria basilar para a região de perfusão cerebral reduzida. O objetivo do presente estudo foi comparar a anomalia do Círculo de Willis em pacientes com doença carotídea assintomática e sintomática unilateral. Resultados: Neste estudo retrospectivo, foram analisados 175 pacientes que foram à nossa clínica ambulatorial de AVC, entre janeiro de 2013 e junho de 2015, com doença carotídea assintomática ou sintomática unilateral, e que fizeram angiografia por tomografia computadorizada. Propriedades demográ...

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“…The frequency of A1 hypoplasia was 1–13%, as derived from angiograms and autopsy reports. To the best of our knowledge, no reports have mentioned the probability of dynamic transformation in A1 segments [4]. …”

Section: Resultsmentioning

confidence: 99%

“…Hoksbergen et al [2 ]explained that among the general population, only approximately 50% have a complete CoW; for others a multitude of possible anatomical variations are present, with absent or hypoplastic vessels being quite common. Schomer et al [3] and Chuang et al [4 ]described that the anatomical variations in the CoW [including the posterior communicating artery (PCoA) hypoplasia and A1 hypoplasia] may preclude collateral compensation, which is regarded as a risk factor for ischemic cerebral infarction. Accordingly, early recognition of such anatomical risk factors has been suggested.…”

Section: Background and Purposementioning

confidence: 99%

Plasticity of Circle of Willis: A Longitudinal Observation of Flow Patterns in the Circle of Willis One Week after Stenting for Severe Internal Carotid Artery Stenosis

Chuang

Lin²,

Wong

et al. 2009

Cerebrovasc Dis

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Background and Purpose: The purpose of the present study was to assess whether the direction of flow via the circle of Willis (CoW) changed after stenting for severe internal carotid artery (ICA) stenosis. Methods: 65 patients (38 men, mean age 63.2 ± 8.4 years, range 44–82) with a symptomatic ICA occlusion were investigated. Magnetic resonance angiography was performed prior to and 1 week after carotid artery stenting (CAS). The pattern in the CoW was assessed. Results: One third of the subjects (35.38%) had a significantly altered flow pattern in the CoW after unilateral CAS, including blocked ipsilateral A1 segment collateral (n = 4), blocked contralateral A1 segment collateral (n = 5), blocked ipsilateral posterior communicating artery (PCoA) segment collateral (n = 4), blocked ipsilateral A1 segment and P1 segment collateral (n = 1), opening of ipsilateral A1 segment collateral (n = 5), opening of ipsilateral PCoA segment collateral (n = 3) and opening of ipsilateral P1 segment collateral (n = 1). Conclusions: CoW segmental hypoplasia is not a static feature. Willisian collateralization with recruitment of the CoW segment (A1, P1 and PCoA) may be blocked after CAS. CAS also leads to the opening of new willisian collateralization, either for relief of reperfusion pressure or for other hypoperfused areas.

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Anterior Cerebral Artery A1 Segment Hypoplasia May Contribute to A1 Hypoplasia Syndrome

Cited by 51 publications

References 25 publications

PHACES Association: A Neuroradiologic Review of 17 Patients

PHACES Association: A Neuroradiologic Review of 17 Patients

The association of the circle of Willis anomaly and risk of stroke in patients with carotid artery disease

Plasticity of Circle of Willis: A Longitudinal Observation of Flow Patterns in the Circle of Willis One Week after Stenting for Severe Internal Carotid Artery Stenosis

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