The cerebral arterial circle (circle of Willis) plays an important role in the redistribution of the blood flow between the anterior and posterior territories and maintains the plasticity of the cerebral blood circula...The cerebral arterial circle (circle of Willis) plays an important role in the redistribution of the blood flow between the anterior and posterior territories and maintains the plasticity of the cerebral blood circulation. The anatomical variability of the vascular circle often alters the cerebral hemodynamics and determines the outcomes of acute and chronic cerebrovascular disease. The heritability and prevalence of certain variants of the circle of Willis in different ethnic and racial groups are frequently disputed by authors. Our cross-sectional retrospective study aims to compare the patterns of the cerebral arterial circle in 64 Caucasian cadavers with 64 Arabic living individuals, by methods of anatomic dissection and magnetic resonance angiography, respectively. The typical structure of the circle of Willis was revealed in 8.3% of the Caucasian study group, and in 22.2% of the Arabic one. The anterior part of the circle of Willis was incomplete in 6 out of 64 of the Caucasian specimens, where the anterior communicating artery was hypoplastic (6.3%) or absent (3.1%). The posterior part of the circle of Willis had hypoplastic or absent posterior communicating artery on one side in 20, and on both sides in 12 out of 64 Caucasian specimens. In the Arabic cohort, the posterior part of the circle of Willis was incomplete in 17 out of 64 specimens, with absence of the posterior communicating artery unilaterally (in 11 cases) or bilaterally (in 6 cases). The present study reveals that the configuration of the cerebral arterial circle and distribution of the blood flow between the anterior and posterior territories have certain differences in the Caucasian study group versus the Arabic one.展开更多
Background:The aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery(PComA)aneurysms originating from fetal posterior cere...Background:The aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery(PComA)aneurysms originating from fetal posterior cerebral artery(fPCA)and analyze the risk factors for the postoperative radiological infarction and outcome.Methods:From 2011 to 2020,we retrospectively reviewed 74 PComA aneurysms originating from fPCA in terms of the clinical and radiological features and obtained the follow-up data from the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University.The relationships between these features and follow-up data were assessed with the univariate and multivariate analysis.Results:In this series,74 aneurysms were occurring at the origin of fPCAs.All the patients showed complete obliteration of their aneurysms.Full fPCA type tends to be a predictive factor for radiological infarction(univariateχ^(2)=5.873,P=0.027;multivariate OR=0.264,P=0.060).Postoperative radiological infarction(univariateχ^(2)=12.611,P=0.001;multivariate OR=6.033,P=0.043),rupture(univariateχ^(2)=4.514,P=0.047;multivariate OR=57.966,P=0.044),and hypertension(univariateχ^(2)=5.301,P=0.024;multivariate OR=24.462,P=0.029)tend to be the independent predictive factors for poor prognosis at 3 months after discharge.Conclusions:In conclusion,we report a series of patients harboring aneurysms originating from the fPCA.Surgical clipping is a reliable strategy.Full fPCA type is related to postsurgical infarction.Postoperative radiological infarction,rupture,and hypertension tend to be the independent predictive factor for poor prognosis at 3months after discharge.展开更多
Percheron动脉(artery of Percheron,AOP)属于丘脑旁正中动脉的一种先天变异[1],国内曾报道过伴单侧胚胎型大脑后动脉(fetal Origin of the Posterior Cerebral Artery,FTP)的AOP梗死[2,3],在这里我们报道1例伴双侧FTP的AOP梗死。1临床...Percheron动脉(artery of Percheron,AOP)属于丘脑旁正中动脉的一种先天变异[1],国内曾报道过伴单侧胚胎型大脑后动脉(fetal Origin of the Posterior Cerebral Artery,FTP)的AOP梗死[2,3],在这里我们报道1例伴双侧FTP的AOP梗死。1临床资料患者,男,58岁,因“发现意识不清1 h”入院。患者夜间睡眠中起病,1 h前晨起时家属发现患者意识不清(距离确定患者正常的时间为7 h),表现为呼之不应,疼痛刺激后有躲避动作。展开更多
文摘The cerebral arterial circle (circle of Willis) plays an important role in the redistribution of the blood flow between the anterior and posterior territories and maintains the plasticity of the cerebral blood circulation. The anatomical variability of the vascular circle often alters the cerebral hemodynamics and determines the outcomes of acute and chronic cerebrovascular disease. The heritability and prevalence of certain variants of the circle of Willis in different ethnic and racial groups are frequently disputed by authors. Our cross-sectional retrospective study aims to compare the patterns of the cerebral arterial circle in 64 Caucasian cadavers with 64 Arabic living individuals, by methods of anatomic dissection and magnetic resonance angiography, respectively. The typical structure of the circle of Willis was revealed in 8.3% of the Caucasian study group, and in 22.2% of the Arabic one. The anterior part of the circle of Willis was incomplete in 6 out of 64 of the Caucasian specimens, where the anterior communicating artery was hypoplastic (6.3%) or absent (3.1%). The posterior part of the circle of Willis had hypoplastic or absent posterior communicating artery on one side in 20, and on both sides in 12 out of 64 Caucasian specimens. In the Arabic cohort, the posterior part of the circle of Willis was incomplete in 17 out of 64 specimens, with absence of the posterior communicating artery unilaterally (in 11 cases) or bilaterally (in 6 cases). The present study reveals that the configuration of the cerebral arterial circle and distribution of the blood flow between the anterior and posterior territories have certain differences in the Caucasian study group versus the Arabic one.
基金supported by the following funds:Special Fund for excellent talents of Dongcheng District of Beijing FY 2018,Principal:X.C.National Natural Science Foundation(81671129),Principal:S.W.
文摘Background:The aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery(PComA)aneurysms originating from fetal posterior cerebral artery(fPCA)and analyze the risk factors for the postoperative radiological infarction and outcome.Methods:From 2011 to 2020,we retrospectively reviewed 74 PComA aneurysms originating from fPCA in terms of the clinical and radiological features and obtained the follow-up data from the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University.The relationships between these features and follow-up data were assessed with the univariate and multivariate analysis.Results:In this series,74 aneurysms were occurring at the origin of fPCAs.All the patients showed complete obliteration of their aneurysms.Full fPCA type tends to be a predictive factor for radiological infarction(univariateχ^(2)=5.873,P=0.027;multivariate OR=0.264,P=0.060).Postoperative radiological infarction(univariateχ^(2)=12.611,P=0.001;multivariate OR=6.033,P=0.043),rupture(univariateχ^(2)=4.514,P=0.047;multivariate OR=57.966,P=0.044),and hypertension(univariateχ^(2)=5.301,P=0.024;multivariate OR=24.462,P=0.029)tend to be the independent predictive factors for poor prognosis at 3 months after discharge.Conclusions:In conclusion,we report a series of patients harboring aneurysms originating from the fPCA.Surgical clipping is a reliable strategy.Full fPCA type is related to postsurgical infarction.Postoperative radiological infarction,rupture,and hypertension tend to be the independent predictive factor for poor prognosis at 3months after discharge.
文摘Percheron动脉(artery of Percheron,AOP)属于丘脑旁正中动脉的一种先天变异[1],国内曾报道过伴单侧胚胎型大脑后动脉(fetal Origin of the Posterior Cerebral Artery,FTP)的AOP梗死[2,3],在这里我们报道1例伴双侧FTP的AOP梗死。1临床资料患者,男,58岁,因“发现意识不清1 h”入院。患者夜间睡眠中起病,1 h前晨起时家属发现患者意识不清(距离确定患者正常的时间为7 h),表现为呼之不应,疼痛刺激后有躲避动作。