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Introducing a New Classification System for the Cerebral Arterial Circle of Willis
Author(s) -
Nestor Nicholas,
Ritz Brianna,
Kumar Anil,
Klinkhachorn Penprapa,
Zdilla Matthew
Publication year - 2020
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2020.34.s1.05758
Subject(s) - circle of willis , medicine , anatomy
The cerebral arterial circle of Willis (CoW) is an arterial ring with an extensive range of variation and implications in cerebrovascular disease. Variations of the CoW are implicated in varied pathologies including aneurysms. This study analyzed the variations of the CoW in 177 cadavers. Each vessel in the CoW was identified as normal, hyperplastic, hypoplastic, aplastic, duplicated, triplicated, or plexiform. There were 73 total variation patterns identified. These variations were used to inform the development of a novel classification system that categorizes a CoW into one of 20 morphological types. The categorization is streamlined by assessing the anterior and posterior CoW vasculature independently. The anterior (A) variations are paired with their corresponding posterior (P) variations for a more complete description of the entire CoW variation. An unremarkable CoW is referenced as “A0P0.” The most common variant type is “A0P1” (16.95%) which has a normal anterior and a hypoplastic P1/hyperplastic P2/hyperplastic PCoA. This is followed by “A0P2” (12.99%) which has a normal anterior and a hypoplastic/aplastic PCoA. The circle is incomplete in 9.03% and bilaterally asymmetric in 49.16%. The proposed classification system will help improve the way CoW variations are classified and improve the understanding of how CoW variations are related to cerebrovascular pathology. Support or Funding Information Funding: WV Research Challenge Fund [HEPC.dsr.17.06]