Learning objectives
To illustrate with multidetector computed tomographic (CT) angiographyand digital subtraction angiography (DSA),
the spectrum of variants and anomalies in the supra-aortic trunks (SAT) and Circle of Willis (CW); also,
its relationship with some diseases.
Background
CT angiographyand DSA are used for evaluating the extracraneal and intracranial circulation.Normal variants and anomalies of thesupra-aortic trunks and Circle of Willis,
are common images findings 1
Its knowledge and recognition is important in a radiological report,
in order to make a correct diagnosis,
managementandaid in surgical planning.For example,
the detection of trigeminal artery that frequently connects the internal carotid with the basilar artery,
has a functional consequence,
it creates a reversed in the vertebral system and may cause trigeminal neuralgia and/or subarachnoidal hemorrhage. This...
Imaging findings OR Procedure details
A retrospective analysis including CT angiograms obtained from October 2011 to October 2012and reported by neuroradiologists senior at our institution was performed.
We classified the images findings in normal variants or vascular anomalies.
The most frequent findings in the Circle of Willis are:
1) Normal variants: hypoplasias (25,8%),
fetal presentation of the posterior cerebral artery (12,3%).
2) Anomalies: anterior communicating complex anomalies as anterior cerebral artery azygos or bihemispheric,
abnormalities of the origin of the middle cerebral artery and fenestrations.
At SAT our analysis found:...
Conclusion
This pictorial reviewillustrates the most frequent and relevant cases reported in our institution during one-year period.
Our results compared with the medical literature match in the prevalence and the anomalies associated.
Recognition of these variants and anomalies by the radiologist are important in the diagnosis and management planning.
References
1.DimmickS,FaulderK.
Normal Variants of the Cerebral Circulation at Multidetector CT Angiography.
RadioGraphics.2009; 29:1027-1043.
2.
Whu HM,
Chuang HM.
The clinical relevance of fetal variant of the circle of Willis and its influence on the cerebral collateral circulation.Acta NeurolTaiwan.
2011; 20(4):232-42.
3.
De Silva KR,
Silva R,
Gunasekera WS,
Jayesekera RW.
Prevalence of typical circle of Willis and the variation in the anterior communicating artery: A study of a Sri Lankan population.Ann Indian Acad Neurol.
2009; 12(3):157-61.
4.Pérez-Carrillo GJ,
Hogg JP.Intracranial vascular lesions and anatomical variants...