1.Pattern of circle of Willis between normal subject and patients with carotid atherosclerotic plaque
Hyo Sung Kwak ; Seung Bae Hwang ; Gyung Ho Chung ; Sang Yong
Neurology Asia 2015;20(1):7-14
Objective: We investigated whether circle of Willis (COW) morphology on 3D time-of-flight (TOF)
MR angiography differs between young normal subjects, older normal subjects, and patients with
carotid atherosclerotic plaques. Methods: One hundred seventy-seven subjects were grouped according
to age into a young group (20 – 40 years; n = 91) and an older group (> 60 years; n = 86). Subjects
underwent brain MR examination as part of a health check-up. Fifty-three patients with carotid
atherosclerotic plaque were also included for evaluation in this study. COW morphology on 3D TOF
MR angiography was analyzed in terms of completeness or incompleteness of the anterior and posterior
components of the circle and completeness of the circle. Results: An incomplete pattern of anterior
circulation was significantly more common in carotid atherosclerotic plaque patients (20.7%) than
normal older subjects (5.5%) (p < 0.01). A complete posterior circulation pattern was more frequent
in normal young subjects (46.5%) than in normal older subjects (16.5%) or the patient group (18.9%)
(p < 0.01). Of patients with carotid artery stenosis, 18.9% had a bilateral incomplete connection and
were significantly more likely to have an incomplete pattern than normal young (2.3%) or normal
older subjects (2.2%) (p < 0.001).
Conclusion: Young, healthy subjects were significantly more likely to have a complete pattern of posterior
circulation than older subjects. Patients with carotid atherosclerotic plaques were significantly more
likely to have incomplete anterior circulation and an incomplete circle than young, normal subjects.
Circle of Willis
2.Usefulness of Computed Tomographic Angiography in the Detection and Evaluation of Aneurysms of the Circle of Willis.
Hyuk Gi LEE ; Jae Hoon CHO ; Sung Lak LEE ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 2000;29(3):345-352
No abstract available.
Aneurysm*
;
Angiography*
;
Circle of Willis*
4.Angiographic Analysis of the Circle of Willis: Comparison between Atherosclerosis and Normal Groups.
Eun Hye LEE ; Dae Chul SUH ; Choong Gon CHOI ; Ho Kyu LEE ; Tae Hwan LIM ; Yong Ho AUH
Journal of the Korean Radiological Society 1999;41(4):651-656
PURPOSE: To determine differences in angiographic variations of the circle of Willis between atherosclerosis and normal groups. MATERIALS AND METHODS: In 289 patients we reviewed complete cerebral angiograms obtained using biplane digital subtraction angiography. Atherosclerosis was diagnosed in 189 patients, while 100 were normal. Patients were divided into four subgroups according to the relative size of each segment and the presence of cross-filling of opposite-sided vessels. When the circle was completely present, we determined whether or not it was balanced, and statistically compared variation patterns between the two groups. RESULTS: In the atherosclerosis group, the anterior half of the circle was complete in 74% of cases(139/189), and the posterior half in 38% (72/189). In the normal group, the anterior half was complete in 90% of cases, and the posterior half in 63%. An incomplete circle was more common in the atherosclerosis group than among normal subjects (26% vs 10%, p<.05; 62% vs 37%, p<.001). In the atherosclerosis group with incomplete circle, agenesis was found in the anterior communicating artery in 19% of cases (36/189), the A1 segment in 7% (14/189), the posterior communicating artery in 58% (109/189), and the P1 segment in 7% (14/189). In the normal group with incomplete circle, agenesis was seen in the anterior communicating artery in 9% of cases, in the A1 segment in 1%, in the posterior communicating artery in 36%, and in the P1 segment in 3%. Agenesis of the anterior communicating artery (19% vs 9%, p<.05), the A1 segment (7% vs 1%, p<.05), or the posterior communicating artery (58% vs 36%, p<.001) was more common in the atherosclerosis group than in the normal group. Unbalanced type with a size discrepancy between A1 segments was also more common in the atherosclerosis group (19% vs 8%, p<.05). There was no significant difference between the two groups regarding posterior communicating arteries equal to or larger than the P1 segment (42% vs 27%, p>.05) and agenesis of the P1 segment (7% vs 3%, p>.05). CONCLUSION: An incomplete and unbalanced circle of Willis was more common in the atherosclerosis group than in the normal group. Agenesis of the anterior communicating artery, the A1 segment, or the posterior communicating artery was common in the atherosclerosis group, as was size discrepancy between A1 segments.
Angiography, Digital Subtraction
;
Arteries
;
Atherosclerosis*
;
Circle of Willis*
;
Humans
;
Intracranial Arteriosclerosis
5.Surgical Results of Encephaloduroarteriomyosynangiosis(EDAMS) for Moyamoya Desease.
Seung Ho HEO ; Young Shin RA ; Moon Jun SOHN ; Jung Hoon SOHN ; Sung Woo ROH ; Chang Jin KIM ; Yang KWON ; Seung Chul RHIM ; Jung Kyo LEE ; Byung Duk KWUN
Journal of Korean Neurosurgical Society 1999;28(3):340-346
Moyamoya disease is a cerebrovascular disease of unknown etiology which leads to spontaneous occlusion of circle of Willis. Cerebral ischemic or hemorrhagic episodes occur as moyamoya disease progresses. To establish an efficient collateral circulation for the ischemic brain of this disease many surgical the therapeutic methods have been proposed. We analyzed the surgical results of encephaloduroarteriomyosynangiosis(EDAMS) and compared with that of direct bypass surgery, superfical temporal artery to middle ce rebral artery(STA-MCA) anastomosis to determine the efficacy of new indirect revascularization procedure, EDAMS, in the treatment of moyamoya disease. Twenty three patients with moyamoya disease who underwent revascularization procedure were included in this study. EDAMS was performed on 18 sides in 16 patients and STA-MCA anastomosis was done on 12 sides in 7 patients. Two patients underwent encephaloduroarteriosynangiosis(EDAS). The surgical results of EDAMS were excellent to good in 14 patients and fair in 2 patients. No statistical significance of the outcome was observed in comparision of EDAMS and STA-MCA anastomosis(p-value=0.471). Regardless of surgical procedures, outcome of child-onset moyamoya disease was found to be superior to those of adult-onset moyamoya disease(p-delete=0.024). In conclusion, EDAMS is considered to be one of the effective indirect revascularization methods to prevent the ischemic attack and establish the revascularization for moyamoya disease.
Brain
;
Circle of Willis
;
Collateral Circulation
;
Humans
;
Moyamoya Disease
;
Temporal Arteries
6.A Case of Familial Moyamoya Disease: A Case in Brother and Sister.
Hyoung Ock RYU ; Nyeon Cheon KIM ; Eun Sook SUH ; Bak Jang BYUN
Journal of the Korean Child Neurology Society 2004;12(2):241-246
Moyamoya disease is a progressive and occlusive disorder of the cerebral vasculature with particular involvements of the circle of Willis and the arteries that feed it. It occurs commonly in Japan and Korea, but less frequently in the Western countries. The etiology of moyamoya disease is still unclear, but frequent familial occurrence suggests that some genetic factors may be important in its etiology. Approximately 7-10% of moyamoya disease are familial. We experienced 2 siblings with moyamoya disease, and report the case with a review of previously published cases of moyamoya disease within a family.
Arteries
;
Circle of Willis
;
Humans
;
Japan
;
Korea
;
Moyamoya Disease*
;
Siblings*
7.Microsurgical Anatomy of Circle of Willis in Korean Cadavaric Specimen.
Jong Hyeon SHIN ; In Suk HAMM ; Seung Lae KIM
Journal of Korean Neurosurgical Society 1995;24(10):1113-1120
The authors studied and analyzed microscopically the structure, length and diameter of each part of Willis circle in 264 cerebral hemispheres of 182 autopsied patients in the Taegu area from 1984 to 1990. The mean length of each A1 was 14.1mm and diameter at distal A1 was 2.25mm. The most common anatomical anomaly of the ACA part was A1 that of hypoplasia which appeared in 7.5% of the cases. The origin of the Heuner a. was accounted for the highest incidence of AcoA(82.5%). The length of AcoA. Noted 3.5mm with the incidence of duplication and triplication in 38.6%. The inner diameter of ICA noted 3.9mm at the communicating segment in ICA, and the average length of C4 was 12.5m. Except 5 hemispheres of undetectable origin at ICA, all the anterior choroidal a. originated from ICA, and the double stump of which noted 15.5%. Fetal type PcoA. Showed 6.6% of all and average length of the a. was 13.5mm. The inner diameter of MCA was 3.1mm and the mean length of M1 noted 15.5mm. The length of each P1 noted 6.95mm and the inner diameter of basilar a. at 1cm below the bifurcation was 3.3mm. The mean circumference of willis circle including both side of A1, P1, PcoA. AcoA. And choroidal and communicating segment of ICA was 88.6mm. Incidental finding of unruptured aneurysm noted 5.3% and junctional dilatation of PcoA. Showed 11.4% of all the cases.
Aneurysm
;
Cerebrum
;
Choroid
;
Circle of Willis*
;
Daegu
;
Dilatation
;
Humans
;
Incidence
;
Incidental Findings
8."Misery Collaterals" as Poor Angiographic Findings: Definition, Classification, and Practical Application.
Journal of Korean Neurosurgical Society 2006;40(3):159-163
OBJECTIVE: Unique internal carotid artery angiographic findings have been found especially in very poor grade aneurysmal subarachnoid hemorrhage(SAH) patients before and during the endovascular coiling. The author investigates their patterns and classifies them into four subtypes. METHODS: Among Hunt&Hess grade IV, V SAH patients, the author could gather eight patients who showed abnormal intracranial circulation in cerebral catheter-based angiography. RESULTS: The author introduces new term 'misery collaterals' first and has classified them into four types with the case illustrations. Type 1 is the worst condition defined as almost no intracranial circulation. Type 2 is the condition of little intracranial circulation with contrast filling just only at vessels of brain base, type 3 is of no or little cortical circulation with contrast filling at bilateral large vessels of brain base through circle of Willis channel and type 4 is of visible bilateral cortical circulation but delayed intracranial circulation time. The prognosis of these eight patients showed misery collaterals were disappointed. CONCLUSION: These finding can be used as the supportive information in deciding a management plan in poor grade SAH patients.
Aneurysm
;
Angiography
;
Brain
;
Carotid Artery, Internal
;
Circle of Willis
;
Classification*
;
Humans
;
Prognosis
9.Usefulness of CT Angiography in Patients with Intracranial Occlusive Vascular Disease of the Circle of Willis: Comparison with Conventional Angiography.
Byoung Jin KIM ; Yun Hyeon KIM ; Jeong Jin SEO ; Jin Yong CHONG ; Jae Kyu KIM ; Jin Gyoon PARK ; Heoung Keun KANG
Journal of the Korean Radiological Society 1996;35(3):301-306
PURPOSE: To assess the usefulness of CT angiography(CTA) compared with compared with conventional angiography(CA) in the evaluation of intracranial occlusive vascular disease. MATERIALS AND METHODS: We evaluated 26 patients with clinically suspected intracranial occlusive vascular disease studied with both CTA and CA. Incases where there was no vascular lesion on CA, we used CTA to retrospectively review the detection rate and size of individual vessels, and compared the findings with those obtained by CA. In cases of occlusive vascular lesion, we evaluated the degree of stenosis on CTA and compared this with the CA findings. We also measured the time taken to use both modalities. RESULTS: Sixteen patients had no vascular lesion and ten patients had occlusive vascularlesions. Compared with CA, CTA detected 97%(124/128) of normal intracranial arteies ; their diameter measured on CTA was slightly smaller than that on CA. On CTA, the degree of stenosis was correctly estimated in eight lesions, underestimated in one and overestimated in one. Examination time ranged between 15 and 20 minutes with CTA and between 40 and 60 minutes with CA. CONCLUSION: Compared with CA, CTA shows good correlation in the delineation of intracranial normal and occlusive vessels around the Circle of Willis. CTA may be an additional tool for the evaluation of the Circle of Willis in patients with suspected intracranial occlusive vascular disease. CTA may, additionally, be used as a follow-up method in patients with acute cerebral infarctions after thrombolytic therapy.
Angiography*
;
Cerebral Infarction
;
Circle of Willis*
;
Constriction, Pathologic
;
Humans
;
Retrospective Studies
;
Vascular Diseases*
10.The usefulness of thin-section rapid infusion CT for detection of cerebral aneurysm.
Jong Min KIM ; So Sun KIM ; Jin Do HUH
Journal of the Korean Radiological Society 1993;29(6):1116-1120
With 2mm-thick CT scanning during the rapid infusion of contrast material(TICT), cerebral aneurysms arising from the circle of Willis and adjacent vessels can be directly visualized. Twenty-five patients who had cerebral aneurysm confirmed by surgery were examined with TIGT and digital subtraction angiography. The authors examined TIGT prospectively to assess the detection rate of the cerebal aneurysms and to evaluate the clinical usefulness of TIGT. The detection rates of aneurysms by TIGT and digital subtraction angiography were 68% and 84%, respectively. TIGT is a rapid, safe and reliable method in the evaluation of patients with suspected cerebral aneurysm, permitting direct visualization of the aneurysm.
Aneurysm
;
Angiography, Digital Subtraction
;
Circle of Willis
;
Humans
;
Intracranial Aneurysm*
;
Methods
;
Prospective Studies
;
Tomography, X-Ray Computed