Assessment of Anatomical Variations and Cerebral Vessel Diameters in Ischemic Stroke Patients Using CT Angiography Examination

Abstract

Background: Willis Polygon (WP), cerebral circulation, and brain function are closely linked. Anatomical variations may contribute to cerebrovascular diseases, making their understanding vital for assessing stroke risk. Exploring the relationship between WP variations and vessel diameters holds clinical significance. The aim of this study was to investigate different anatomic variations and dimensions of WP in patients with ischemic stroke.

Methods: This observational, descriptive, and retrospective study evaluated CW anatomy in 132 ischemic stroke patients and 130 controls using CT angiography. WP arterial diameters were measured, and variations recorded.

Results:  In the ischemic stroke patient group, anterior system variation was 48.9% and posterior system variation was 51%, with no significant difference compared to controls (p=0.5). Diameters of right and left internal carotid arteries (ICA), A1 segment, and middle cerebral artery (MCA) were significantly lower in the study group. However, no significant differences were found in diameters of the basilar artery and the P1 segment of the right and left posterior cerebral arteries between groups.

Conclusion: In our study, no significant differences were found in WP variation and basilar artery and P1 segment of posterior cerebral arteries between ischemic stroke patients and the normal population. However, arterial diameters (bilateral ICA, A1, MCA) were significantly lower in the ischemic stroke group compared to controls. In conclusion, arterial calibrations forming the anterior circulation of the Willis polygon were notably lower in patients with anterior circulation infarction, suggesting a significant role of decreased arterial diameters in ischemic stroke pathophysiology.