Variant anatomy of the cerebral arterial circle: relationship with skull shape
REVIEWS
Abstract
Introduction. The cerebral arterial circle (circle of Willis) is a key structure ensuring intersystemic blood flow. The classical closed configuration is found in no more than 25–50% of cases, and the skull shape may influence the topography of its arterial segments. The aim of this study was to systematize current knowledge on the variants of the cerebral arterial circle and to analyze the relationship between these variants and craniometric characteristics. Materials and methods. A review of publications indexed in Pub Med, Scopus, and e Library databases for the period 2000–2024 was performed. In parallel, the authors' own material was analyzed, comprising MSCT angiographies of patients from a municipal multidisciplinary hospital in Saint Petersburg. Results. The most common deviations from the classical configuration include hypoplasia or aplasia of one or both posterior communicating arteries, as well as the fetal type of the posterior cerebral artery. Dolichocephalic individuals showed a tendency toward a higher frequency of incomplete variants of the posterior part of the circle, whereas brachycephalic individuals more often exhibited a closed configuration. Conclusions. Skull shape may be considered one of the predictors of the anatomical variant of the cerebral arterial circle, which is relevant for assessing individual risk of cerebrovascular events.
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