98%
921
2 minutes
20
Background: The anterior (AcomA) and posterior communicating arteries (PcomA) are two of the most frequent sites for intracranial aneurysms. Anatomical variations in the Circle of Willis (COW) are frequently observed in patients with AcomA and PcomA aneurysms. Strong evidence is needed to determine the pooled estimate of the effect of COW variations on the formation and rupture of these aneurysms.
Aim: This systematic review and meta-analysis aimed to establish the effect of COW variations on the formation and rupture of AcomA and PcomA aneurysms using available studies.
Summary Of Review: PubMed, Embase, and Web of Science databases were systematically searched for studies published in English before September 21, 2022. Studies investigating AcomA aneurysms and the hypoplastic/aplastic A1 segment of the anterior cerebral artery and PcomA aneurysms and hypoplastic/aplastic PcomA or fetal-type posterior cerebral artery (FTP) were included. The heterogeneity of the studies was assessed using Cochran -test and I statistic. Pooled estimate was assessed using either a random- or fixed-effects model based on the heterogeneity of the studies. Among the 4,932 studies, 21 were eligible and included in the analysis. The presence of hypoplastic/aplastic A1 was significantly correlated with the formation [OR (95% confidence interval [CI]) = 7.97 (5.58, 11.39), < 0.001] and rupture [OR (95%CI) = 1.87 (1.29, 2.72), < 0.001] of AcomA aneurysms. Significant associations between FTP and both the formation [OR (95%CI) = 2.15 (1.41, 3.30), < 0.001] and rupture [OR (95%CI) = 1.72 (1.26, 2.36), < 0.001] of PcomA aneurysms were observed.
Conclusions: Significant associations were observed between COW variations and both the formation and rupture of AcomA and PcomA aneurysms. This can help in determining interventions for patients with aneurysms.
Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225149, identifier: CRD42021225149.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885143 | PMC |
http://dx.doi.org/10.3389/fneur.2022.1098950 | DOI Listing |
Surg Radiol Anat
August 2025
Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Jakubowskiego 2 Street, 30-688, Kraków, Poland.
Introduction: The Circle of Willis, located at the base of the brain, is a complex anastomotic ring that ensures blood flow between anterior and posterior cerebral arteries. Its main purpose is to protect against ischemia during vessel failure and sustain cerebral perfusion. Variants occurring in CoW are in over half of the population, usually seen in PComA, as unilateral or bilateral artery hypoplasia or aplasia.
View Article and Find Full Text PDFSurg Radiol Anat
May 2025
Neuroradiology Unit, Ospedale Santa Maria della Misericordia, AULSS 5 Polesana, Rovigo, Italy.
Purpose: This study aims to present a rare case of total bilateral duplication of the posterior communicating artery (PComA), which has been infrequently documented in the literature, and to discuss its anatomical and embryological implications.
Methods: We describe the case of a 45-year-old woman who underwent Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) for sudden onset tinnitus, revealing incidental findings of a dual fenestration of the right A1 anterior cerebral artery (ACA) and an azygos A2 ACA pattern. Notably, total duplication of the PComA was discovered bilaterally, confirmed by Computed Tomography Angiography (CTA).
Cureus
February 2025
Neurological Surgery, Ain Shams University, Cairo, EGY.
Background Aneurysms of the anterior circulation are the most prevalent of intracranial aneurysms, most of which are saccular. Wide-neck aneurysms (WNAs) are a specific subtype of intracranial aneurysms that are difficult to treat. Adequate endovascular management of such aneurysms requires assistive devices that are either too costly or sometimes unavailable in our setting as a resource-limited country, strongly supporting the resurgence of microsurgical clipping in the management of such understudied aneurysms.
View Article and Find Full Text PDFArteriovenous malformations (AVMs) are high-risk cerebrovascular anomalies that can lead to devastating complications, especially when associated with intracranial aneurysms. Their coexistence poses unique challenges in diagnosis and management due to heightened hemodynamic stress and rupture risks. This case presents a 35-year-old woman with a giant unruptured left frontal AVM and a bilobed posterior communicating artery (PComA) aneurysm, highlighting the critical role of advanced imaging, meticulous surgical planning, and individualized care in addressing complex cerebrovascular conditions.
View Article and Find Full Text PDFRadiol Case Rep
April 2025
Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China.
There are no reports of the coexistence of a right vertebral artery (VA) originating from the right common carotid artery (CCA), an aberrant right subclavian artery (SCA) and a primitive proatlantal intersegmental artery (PPIA); thus, we report such a case. A 61-year-old female presented with subarachnoid hemorrhage. Computed tomography angiography (CTA) and digital subtraction angiography (DSA) revealed a ruptured right posterior communicating artery (PcomA) aneurysm.
View Article and Find Full Text PDF