Types of the cerebral arterial circle (circle of Willis) in a Sri Lankan population
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Protocol for Isolating the Mouse Circle of Willis
Published on: October 22, 2016
K Ranil D De Silva1, Rukmal Silva, Dhammika Amaratunga
1Department of Anatomy, University of Sri Jayewardenepura, Nugegoda, Sri Lanka. ranilds@sltnet.lk
Insights
Anatomical variations of the circle of Willis are common across ethnic groups. This study identified 15 known and one new variation in Sri Lankan cadavers, highlighting significant inter-ethnic differences.
Area of Science:
- Neuroanatomy
- Vascular Anatomy
- Human Anatomy
Background:
- Variations in the circle of Willis (CW) impact collateral circulation and stroke risk.
- Understanding CW anatomy is crucial for assessing cerebrovascular disease risk.
Purpose of the Study:
- To investigate anatomical variations of the circle of Willis (CW) in Sri Lankan cadavers.
- To compare the prevalence of CW variations with international autopsy studies.
Main Methods:
- External diameters of CW arteries were measured in 225 Sri Lankan adult cadavers.
- Statistical analyses (chi-squared, correspondence analysis) compared CW variation frequencies across diverse ethnic populations.
Main Results:
- Fifteen previously described CW variations and one new type were identified.
- Significant differences in CW variation prevalence were observed between ethnic groups (p < 0.0001).
- Notable variations included hypoplastic arteries (A1, P1, PcoA) and the anterior communicating artery (AcoA).
Conclusions:
- Significant intra- and inter-ethnic variations exist in the circle of Willis.
- Further research is needed with standardized measurement methods and hypoplasia definitions.
Background:
The variations of the circle of Willis (CW) are clinically important as patients with effective collateral circulations have a lower risk of transient ischemic attack and stroke than those with ineffective collaterals. The aim of the present cadaveric study was to investigate the anatomical variations of the CW and to compare the frequency of prevalence of the different variations with previous autopsy studies as variations in the anatomy of the CW as a whole have not been studied in the Indian subcontinent.
Methods:
The external diameter of all the arteries forming the CW in 225 normal Sri Lankan adult cadaver brains was measured using a calibrated grid to determine the prevalence in the variation in CW. Chisquared tests and a correspondence analysis were performed to compare the relative frequencies of prevalence of anatomical variations in the CW across 6 studies of diverse ethnic populations.
Results:
We report 15 types of variations of CW out of 22 types previously described and one additional type: hypoplastic precommunicating part of the anterior cerebral arteries (A1) and contralateral posterior communicating arteries (PcoA) 5(2%). Statistically significant differences (p < 0.0001) were found between most of the studies except for the Moroccan study. An especially notable difference was observed in the following 4 configurations: 1) hypoplastic precommunicating part of the posterior cerebral arteries (P1), and contralateral A1, 2) hypoplastic PcoA and contralateral P1, 3) hypoplastic PcoA, anterior communicating artery (AcoA) and contralateral P1, 4) bilateral hypoplastic P1s and AcoA in a Caucasian dominant study by Fisher versus the rest of the studies.
Conclusion:
The present study reveals that there are significant variations in the CW among intra and inter ethnic groups (Caucasian, African and Asian: Iran and Sri Lanka dominant populations), and warrants further studies keeping the methods of measurements, data assessment, and the definitions of hypoplasia the same.
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