Association of Normal Variation of Circle of Willis with Site of Cerebral Aneurysm
Journal Title: Nepal Journal of Neuroscience - Year 2014, Vol 11, Issue 1
Abstract
A large number of western researches shows that Circle of Willis (CW) is not always presented as normal and frequently the variation is associated with development of a cerebrovascular disease including aneurysms. But suffi cient study is lacking on this subject in the South East region including Nepal. This study intends to analyse the variation in the CW in the Nepalese in a tertiary referral centre and compare it with the results of other published series. This is a retrospective longitudinal analytical study of the patients, admitted to our institute over a period of two year with the diagnosis of spontaneous subarachnoid hemorrhage (SAH), who underwent digital subtraction angiogram (DSA). All the patients in the study group were evaluated radiologically for normal variation of CW and its correlation with site of vascular pathology. Data obtained from medical record section were analysed using computer software version SPSS16. Study population was 124 with M:F = 9:5. Age ranged from 13 to 79 year with mean of 46.41. Total cases with CW variation were 50. Total vascular pathology was 46 with 42 aneurysms and 4 arteriovenous malformation (AVM). Anterior communicating (ACom) aneurysm comprised 16 cases followed by middle cerebral (MCA) 8 cases and posterior communicating (PCom) 7 cases. Cases with Acom and Pcom aneurysms had 7 A type (P: 0.027) and 5 P type (P:0.005) variations respectively. Cases with MCA aneurysm and AVM had 4 (P:0.694 ) and 1 (P : 0.647) variations only. This study shows that variation of CW is common in the Nepalese. There is a signifi cant correlation between ACom aneurysm & Type A variation and PCom aneurysm & Type P variation. However there was no signifi cant correlation between the MCA aneurysm & variation of CW.
Authors and Affiliations
Ramesh N M Joshi, MS, MCh
Keywords
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