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Circle of Willis variation in a complex stroke presentation: a case report.
Hedley C A Emsley1, Carolyn A Young, Richard P White
1Division of Neuroscience, University of Liverpool, The Walton Centre for Neurology & Neurosurgery, Liverpool L9 7LJ, UK. h.emsley@liv.ac.uk
BMC Neurology
|March 17, 2006
Summary
Anatomical variations in the Circle of Willis can significantly alter stroke presentation, mimicking spinal cord injury. This case highlights how these variations impact large vessel cerebrovascular disease expression.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroanatomy
Background:
- The Circle of Willis's anatomical variations are underrecognized factors influencing stroke presentation.
- Understanding these variations is crucial for accurate diagnosis and treatment of cerebrovascular disease.
Observation:
- A patient presented with sequential left hemiparesis and right leg weakness after a road traffic accident.
- Initial symptoms suggested a possible cervical spinal cord injury.
Findings:
- The final diagnosis was bilateral artery-to-artery embolic cerebral infarction.
- A dominant right internal carotid artery was noted in the context of Circle of Willis anatomical variation.
Implications:
- This case demonstrates stroke presenting as a pseudo-cervical cord lesion.
- Circle of Willis anatomical variations significantly affect the clinical expression of large vessel cerebrovascular disease.