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Cerebral Catheter Angiography Findings in Adult Filipinos: A Quantitative Study of Intracranial Vessel Diameters and
Miguel Nicolai T Victorino1, Reynaldo Benedict V Villamor1, Anna Marie L Bernardo1
1Neurosurgery, Vicente Sotto Memorial Medical Center, Cebu City, PHL.
Insights
This study establishes normal intracranial vessel sizes for Filipino adults, finding they are smaller than international averages. These Filipino-specific norms are crucial for accurate diagnosis and neurosurgical planning in the local population.
Area of Science:
- Neurology
- Radiology
- Vascular Anatomy
Background:
- Cerebral catheter angiography is vital for diagnosing cerebrovascular disorders.
- Normative data for intracranial vessel characteristics in healthy Filipino adults are currently lacking.
- Individual variations necessitate Filipino-specific vessel size norms for improved clinical management.
Purpose of the Study:
- To establish normative data for intracranial vessel diameters in healthy adult Filipinos.
- To compare Filipino vessel sizes with international standards.
- To provide essential reference data for neurodiagnosis and neurosurgical planning in the Philippines.
Main Methods:
- Retrospective analysis of 73 cerebral catheter angiograms from 1099 patients (2015-2021).
- Exclusion of patients with vascular pathologies, under 18, atherosclerosis, or vasospasm.
- Calculation of mean diameters, standard deviations, and confidence intervals; assessment of normality and laterality differences.
Main Results:
- Normal intracranial vessel diameter ranges (mm) were established for Filipino adults.
- Filipino vessel diameters were found to be smaller than those reported in international studies.
- Significant laterality differences were observed in the anterior cerebral artery (ACA) A1 segment, posterior communicating artery (PCOM), and transverse sinus.
Conclusions:
- This study provides the first comprehensive normal intracranial vessel size data for adult Filipinos.
- Filipino intracranial vessel diameters are smaller than international norms, likely due to ethnic and methodological factors.
- The established norms and observed variations in arterial flow and sinus dominance aid in the clinical management of Filipino patients.
Abstract:
Introduction Cerebral catheter angiography is crucial for cerebrovascular disorder diagnosis, but local normative data on intracranial vessel characteristics in healthy Filipino adults are lacking. Individual variations in Circle of Willis components highlight the need for establishing Filipino-specific vessel size norms to aid diagnosis and neurosurgical planning. Methods This retrospective study analyzed 73 cerebral catheter angiograms from 1099 patients at Vicente Sotto Memorial Medical Center (2015-2021). Patients with known vascular pathologies or under 18 were excluded; 222 angiograms were further excluded for atherosclerosis/vasospasm. Mean, standard deviation, and 95% confidence intervals were computed for vessel diameters. Normality (Kolmogorov-Smirnov, Shapiro-Wilk) and laterality differences (Levene's, t-tests) were assessed. Anterior cerebral artery (ACA) flow patterns and transverse sinus dominance were reported as percentages. All analyses used IBM SPSS Statistics for Windows (IBM Corp., Version 22.0, Armonk, NY). Results Normal intracranial vessel diameter ranges (mm) were as follows: internal carotid artery (ICA) supraclinoid (3.37-3.74), middle cerebral artery (MCA) M1 (2.54-2.74), MCA M2 superior (1.83-1.99), MCA M2 inferior (1.79-1.96), posterior cerebral artery (PCA) (1.82-2.00), superior cerebellar artery (SCA) (1.22-1.34), posterior inferior cerebellar artery (PICA) (1.46-1.66), vertebral artery (2.99-3.38), basilar artery (3.14-3.45). Significant laterality differences (mm) were found for ACA A1: right (1.87-2.01), left (1.93-2.20); posterior communicating artery (PCOM): right (1.69-1.78), left (1.57-1.98); and transverse sinus: right (6.68-7.90), left (5.14-6.11). Anterior cerebral flow was 53.4% symmetrical (23.3% right-dominant, 23.3% left-dominant). Right transverse sinus dominance was 56.2%, symmetrical inn 28.8%, and left-dominant in 15.1%. Fetal PCOM was 29%. Conclusion This study presents the first comprehensive normal intracranial vessel sizes for adult Filipinos. Filipino vessel diameters are notably smaller than international reports, likely due to ethnicity and measurement methodology. These data serve as a vital reference for managing Filipino patients where vessel size dictates therapeutic, prognostic, and diagnostic decisions. Observed arterial flow patterns and sinus dominance also differ from Western studies, offering further aid in Filipino patient care.
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