Variants of anomalies in the structure of the Willis circle in patients with acute cerebrovascular accident in various vascular beds

Background. The frequency and severity of acute cerebrovascular accident depend on the variants of the anomaly in the structure of the Willis circle.

Aim. To identify the frequency and variants of the Willis circle anomaly in patients with acute cerebrovascular accident with an assessment of the severity of neurological disorders according to the National Institutes of Health Stroke Scale (NIHSS).

Material and methods. The study included 47 patients with acute cerebrovascular accident in conditions of the Willis circle anomaly: 21 male and 26 female, mean age was 67.08±16.03 years. All patients underwent magnetic resonance imaging, magnetic resonance angiography of the brain, neurological examination using NIHSS.

Results. Patients with the absence of one posterior communicating artery had a significant stroke severity according to the NIHSS: 9.429±5.840 points (moderate neurological disorders), p=0.016. The results in patients with the absence of both posterior communicating arteries were 5.667±4.410 (p=0.939), in patients with posterior trifurcation 5.200±6.058 (p=0.864), the group with an anomaly in the form of the absence of all communicating arteries had 4.000±2.828 points (mild neurological disorders), p=0.602. The group of patients with anterior trifurcation showed the lowest results: 3.500±2.121 points (p=0.492). Circulatory disorders in the posterior circulation system were significantly more common in the pathologies of the Willis circle consisting of trifurcation, and less common in other pathologies of the Willis circle, consisting in trifurcation, compared with the group of patients with the absence of at least one communicating artery (p=0.037).

Conclusion. Patients with stroke and the absence of one posterior communicating artery had neurological disorders of moderate severity according to the NIHSS, with the localization of the catastrophe mainly in the left middle cerebral artery circulation; in patients with the absence of both posterior communicating arteries, neurological disorders were of mild severity; patients with stroke in the posterior circulation system more often had an anomaly of the Willis circle in the form of a trifurcation.