Evaluation of the Frequency of Migraine and CVA Patients Based on Circle of Willis Morphological Variations in MRA Images

Abstract

Background: The Circle of Willis (CoW) forms a critical collateral route for the compensation pathway at the basal cistern of the brain. This study aims to determine if migraine headaches and cerebrovascular accidents (CVAs) are associated with the prevalence and patterns of CoW arterial variations seen in the three-dimensional time-of-flight magnetic resonance angiography technique in patients. Materials and Methods: A cross-sectional study was undertaken by a systemic search of electronic databases in the Imaging Center, Abadan’s Taleghani Hospital, Iran, from March 2020 to March 2022. Data on the prevalence of variations in patients who presented for screening for migraine and CVA were extracted and analyzed with Student t-test and the Chi-square method. Results: Findings show complete CoW has been visible in 20.19% of our patients. The anterior part of the CoW was almost intact in all patients. The posterior part of CoW was mostly bilaterally hypoplastic (31.73%) or bilateral aplastic (29.81%) and in some rare cases unilaterally varied. In migraine patients, CoW was rarely in its classic form (15%) and was varied bilaterally in 72.5% of the cases. In CVA patients, CoW was in its complete vascular structure in 23.08% and bilaterally varied in 46.15% of all cases. Conclusions: Overall, migraine and CVA are associated with anatomical variations in the posterior portions of the CoW. Further larger prospective trials are needed to determine the true prevalence of CoW variations and their pathological significance.