Variants of the circle of Willis in ischemic stroke patients
Purpose We aim to provide prevalence and pattern of anatomical variants of circle of Willis in over one thousand ischemic stroke patients compared to an age- and sex-matched control group, and to determine their role in the severity and in-hospital prognosis. Methods Two groups of neuroradiologists...
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| Veröffentlicht in: | Journal of neurology 2021-10, Vol.268 (10), p.3799-3807 |
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| creator | De Caro, Jolanda Ciacciarelli, Antonio Tessitore, Agostino Buonomo, Orazio Calzoni, Andrea Francalanza, Isabella Dell’Aera, Cristina Cosenza, Domenico Currò, Carmelo Tiberio Granata, Francesca Vinci, Sergio Lucio Trimarchi, Giuseppe Toscano, Antonio Musolino, Rosa Fortunata La Spina, Paolino |
| description | Purpose
We aim to provide prevalence and pattern of anatomical variants of circle of Willis in over one thousand ischemic stroke patients compared to an age- and sex-matched control group, and to determine their role in the severity and in-hospital prognosis.
Methods
Two groups of neuroradiologists evaluated all vascular images of ischemic stroke patients and controls to identify anatomical variants using a preexisted classification. We collected data concerning patient characteristics, stroke severity on admission and discharge, in-hospital mortality, hemorrhagic transformation, acute treatment performed, and etiology.
Results
We included 1131 patients with acute ischemic stroke and 562 controls. Among stroke patients, 702 (62.1%) had one or more vascular variants, compared to 308 (54.8%) of the control group (
p
|
| doi_str_mv | 10.1007/s00415-021-10454-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2507668679</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2576105732</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-4110f671a0019aad8b62be59ddb95d9c3a7c02a8aefb3b3310f8c1d046326fa3</originalsourceid><addsrcrecordid>eNp9kMtKxDAUhoMozjj6Ai6k4MZN9eTeghsZvMGAm0GXIU1TJ2MvY9IufHszdlRw4Soczvf_OXwInWK4xADyKgAwzFMgOMXAOEvZHppiRkmKGc_30RQog5RTziboKIQ1AGRxcYgmlMpMCMGn6PpZe6fbPiRdlfQrmxjnTW2304uraxcS1yYumJVtnElC77s3m2x072zMHKODStfBnuzeGVre3S7nD-ni6f5xfrNIDZW8TxnGUAmJNQDOtS6zQpDC8rwsi5yXuaFaGiA607YqaEFppDODS2CCElFpOkMXY-3Gd--DDb1q4kW2rnVruyEowkEKkQmZR_T8D7ruBt_G4yIlBQYuKYkUGSnjuxC8rdTGu0b7D4VBbdWqUa2KatWXWsVi6GxXPRSNLX8i3y4jQEcgxFX7av3v3__UfgK5mIJt</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2576105732</pqid></control><display><type>article</type><title>Variants of the circle of Willis in ischemic stroke patients</title><source>Springer Nature - Complete Springer Journals</source><creator>De Caro, Jolanda ; Ciacciarelli, Antonio ; Tessitore, Agostino ; Buonomo, Orazio ; Calzoni, Andrea ; Francalanza, Isabella ; Dell’Aera, Cristina ; Cosenza, Domenico ; Currò, Carmelo Tiberio ; Granata, Francesca ; Vinci, Sergio Lucio ; Trimarchi, Giuseppe ; Toscano, Antonio ; Musolino, Rosa Fortunata ; La Spina, Paolino</creator><creatorcontrib>De Caro, Jolanda ; Ciacciarelli, Antonio ; Tessitore, Agostino ; Buonomo, Orazio ; Calzoni, Andrea ; Francalanza, Isabella ; Dell’Aera, Cristina ; Cosenza, Domenico ; Currò, Carmelo Tiberio ; Granata, Francesca ; Vinci, Sergio Lucio ; Trimarchi, Giuseppe ; Toscano, Antonio ; Musolino, Rosa Fortunata ; La Spina, Paolino</creatorcontrib><description>Purpose
We aim to provide prevalence and pattern of anatomical variants of circle of Willis in over one thousand ischemic stroke patients compared to an age- and sex-matched control group, and to determine their role in the severity and in-hospital prognosis.
Methods
Two groups of neuroradiologists evaluated all vascular images of ischemic stroke patients and controls to identify anatomical variants using a preexisted classification. We collected data concerning patient characteristics, stroke severity on admission and discharge, in-hospital mortality, hemorrhagic transformation, acute treatment performed, and etiology.
Results
We included 1131 patients with acute ischemic stroke and 562 controls. Among stroke patients, 702 (62.1%) had one or more vascular variants, compared to 308 (54.8%) of the control group (
p
< 0.01), 165/702 (23.5%) had an anterior circulation variant only, 384/702 (54.7%) had a posterior circulation variant only, and 153/702 (21.8%) patients had variants in both anterior and posterior circulation. Patients with variants were older (69.7 ± 13.9 years vs 72.0 ± 12.9 years;
p
= 0.039). The most prevalent variant was the agenesis/hypoplasia of the ACA (201/1131; 17.8%) followed by the unilateral fetal type of the PCA (137/1131; 12.11%).
Conclusions
We provided the prevalence and the pattern of the brain vascular variants of the circle of Willis in a cohort of patients with ischemic stroke. The prevalence of variants was higher in stroke patients compared to controls. Patients with variants were older but had no differences in sex, neurological admission severity, hemorrhagic transformation, etiology, and in-hospital outcome compared to patients with a typical circle of Willis.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-021-10454-4</identifier><identifier>PMID: 33786665</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Etiology ; Fetuses ; Genetic transformation ; Hemorrhage ; Hypoplasia ; Ischemia ; Medicine ; Medicine & Public Health ; Neurology ; Neuroradiology ; Neurosciences ; Original Communication ; Patients ; Stroke</subject><ispartof>Journal of neurology, 2021-10, Vol.268 (10), p.3799-3807</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-4110f671a0019aad8b62be59ddb95d9c3a7c02a8aefb3b3310f8c1d046326fa3</citedby><cites>FETCH-LOGICAL-c375t-4110f671a0019aad8b62be59ddb95d9c3a7c02a8aefb3b3310f8c1d046326fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-021-10454-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-021-10454-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33786665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Caro, Jolanda</creatorcontrib><creatorcontrib>Ciacciarelli, Antonio</creatorcontrib><creatorcontrib>Tessitore, Agostino</creatorcontrib><creatorcontrib>Buonomo, Orazio</creatorcontrib><creatorcontrib>Calzoni, Andrea</creatorcontrib><creatorcontrib>Francalanza, Isabella</creatorcontrib><creatorcontrib>Dell’Aera, Cristina</creatorcontrib><creatorcontrib>Cosenza, Domenico</creatorcontrib><creatorcontrib>Currò, Carmelo Tiberio</creatorcontrib><creatorcontrib>Granata, Francesca</creatorcontrib><creatorcontrib>Vinci, Sergio Lucio</creatorcontrib><creatorcontrib>Trimarchi, Giuseppe</creatorcontrib><creatorcontrib>Toscano, Antonio</creatorcontrib><creatorcontrib>Musolino, Rosa Fortunata</creatorcontrib><creatorcontrib>La Spina, Paolino</creatorcontrib><title>Variants of the circle of Willis in ischemic stroke patients</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Purpose
We aim to provide prevalence and pattern of anatomical variants of circle of Willis in over one thousand ischemic stroke patients compared to an age- and sex-matched control group, and to determine their role in the severity and in-hospital prognosis.
Methods
Two groups of neuroradiologists evaluated all vascular images of ischemic stroke patients and controls to identify anatomical variants using a preexisted classification. We collected data concerning patient characteristics, stroke severity on admission and discharge, in-hospital mortality, hemorrhagic transformation, acute treatment performed, and etiology.
Results
We included 1131 patients with acute ischemic stroke and 562 controls. Among stroke patients, 702 (62.1%) had one or more vascular variants, compared to 308 (54.8%) of the control group (
p
< 0.01), 165/702 (23.5%) had an anterior circulation variant only, 384/702 (54.7%) had a posterior circulation variant only, and 153/702 (21.8%) patients had variants in both anterior and posterior circulation. Patients with variants were older (69.7 ± 13.9 years vs 72.0 ± 12.9 years;
p
= 0.039). The most prevalent variant was the agenesis/hypoplasia of the ACA (201/1131; 17.8%) followed by the unilateral fetal type of the PCA (137/1131; 12.11%).
Conclusions
We provided the prevalence and the pattern of the brain vascular variants of the circle of Willis in a cohort of patients with ischemic stroke. The prevalence of variants was higher in stroke patients compared to controls. Patients with variants were older but had no differences in sex, neurological admission severity, hemorrhagic transformation, etiology, and in-hospital outcome compared to patients with a typical circle of Willis.</description><subject>Etiology</subject><subject>Fetuses</subject><subject>Genetic transformation</subject><subject>Hemorrhage</subject><subject>Hypoplasia</subject><subject>Ischemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Patients</subject><subject>Stroke</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kMtKxDAUhoMozjj6Ai6k4MZN9eTeghsZvMGAm0GXIU1TJ2MvY9IufHszdlRw4Soczvf_OXwInWK4xADyKgAwzFMgOMXAOEvZHppiRkmKGc_30RQog5RTziboKIQ1AGRxcYgmlMpMCMGn6PpZe6fbPiRdlfQrmxjnTW2304uraxcS1yYumJVtnElC77s3m2x072zMHKODStfBnuzeGVre3S7nD-ni6f5xfrNIDZW8TxnGUAmJNQDOtS6zQpDC8rwsi5yXuaFaGiA607YqaEFppDODS2CCElFpOkMXY-3Gd--DDb1q4kW2rnVruyEowkEKkQmZR_T8D7ruBt_G4yIlBQYuKYkUGSnjuxC8rdTGu0b7D4VBbdWqUa2KatWXWsVi6GxXPRSNLX8i3y4jQEcgxFX7av3v3__UfgK5mIJt</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>De Caro, Jolanda</creator><creator>Ciacciarelli, Antonio</creator><creator>Tessitore, Agostino</creator><creator>Buonomo, Orazio</creator><creator>Calzoni, Andrea</creator><creator>Francalanza, Isabella</creator><creator>Dell’Aera, Cristina</creator><creator>Cosenza, Domenico</creator><creator>Currò, Carmelo Tiberio</creator><creator>Granata, Francesca</creator><creator>Vinci, Sergio Lucio</creator><creator>Trimarchi, Giuseppe</creator><creator>Toscano, Antonio</creator><creator>Musolino, Rosa Fortunata</creator><creator>La Spina, Paolino</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20211001</creationdate><title>Variants of the circle of Willis in ischemic stroke patients</title><author>De Caro, Jolanda ; Ciacciarelli, Antonio ; Tessitore, Agostino ; Buonomo, Orazio ; Calzoni, Andrea ; Francalanza, Isabella ; Dell’Aera, Cristina ; Cosenza, Domenico ; Currò, Carmelo Tiberio ; Granata, Francesca ; Vinci, Sergio Lucio ; Trimarchi, Giuseppe ; Toscano, Antonio ; Musolino, Rosa Fortunata ; La Spina, Paolino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-4110f671a0019aad8b62be59ddb95d9c3a7c02a8aefb3b3310f8c1d046326fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Etiology</topic><topic>Fetuses</topic><topic>Genetic transformation</topic><topic>Hemorrhage</topic><topic>Hypoplasia</topic><topic>Ischemia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Original Communication</topic><topic>Patients</topic><topic>Stroke</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>De Caro, Jolanda</creatorcontrib><creatorcontrib>Ciacciarelli, Antonio</creatorcontrib><creatorcontrib>Tessitore, Agostino</creatorcontrib><creatorcontrib>Buonomo, Orazio</creatorcontrib><creatorcontrib>Calzoni, Andrea</creatorcontrib><creatorcontrib>Francalanza, Isabella</creatorcontrib><creatorcontrib>Dell’Aera, Cristina</creatorcontrib><creatorcontrib>Cosenza, Domenico</creatorcontrib><creatorcontrib>Currò, Carmelo Tiberio</creatorcontrib><creatorcontrib>Granata, Francesca</creatorcontrib><creatorcontrib>Vinci, Sergio Lucio</creatorcontrib><creatorcontrib>Trimarchi, Giuseppe</creatorcontrib><creatorcontrib>Toscano, Antonio</creatorcontrib><creatorcontrib>Musolino, Rosa Fortunata</creatorcontrib><creatorcontrib>La Spina, Paolino</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>De Caro, Jolanda</au><au>Ciacciarelli, Antonio</au><au>Tessitore, Agostino</au><au>Buonomo, Orazio</au><au>Calzoni, Andrea</au><au>Francalanza, Isabella</au><au>Dell’Aera, Cristina</au><au>Cosenza, Domenico</au><au>Currò, Carmelo Tiberio</au><au>Granata, Francesca</au><au>Vinci, Sergio Lucio</au><au>Trimarchi, Giuseppe</au><au>Toscano, Antonio</au><au>Musolino, Rosa Fortunata</au><au>La Spina, Paolino</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Variants of the circle of Willis in ischemic stroke patients</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>268</volume><issue>10</issue><spage>3799</spage><epage>3807</epage><pages>3799-3807</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>Purpose
We aim to provide prevalence and pattern of anatomical variants of circle of Willis in over one thousand ischemic stroke patients compared to an age- and sex-matched control group, and to determine their role in the severity and in-hospital prognosis.
Methods
Two groups of neuroradiologists evaluated all vascular images of ischemic stroke patients and controls to identify anatomical variants using a preexisted classification. We collected data concerning patient characteristics, stroke severity on admission and discharge, in-hospital mortality, hemorrhagic transformation, acute treatment performed, and etiology.
Results
We included 1131 patients with acute ischemic stroke and 562 controls. Among stroke patients, 702 (62.1%) had one or more vascular variants, compared to 308 (54.8%) of the control group (
p
< 0.01), 165/702 (23.5%) had an anterior circulation variant only, 384/702 (54.7%) had a posterior circulation variant only, and 153/702 (21.8%) patients had variants in both anterior and posterior circulation. Patients with variants were older (69.7 ± 13.9 years vs 72.0 ± 12.9 years;
p
= 0.039). The most prevalent variant was the agenesis/hypoplasia of the ACA (201/1131; 17.8%) followed by the unilateral fetal type of the PCA (137/1131; 12.11%).
Conclusions
We provided the prevalence and the pattern of the brain vascular variants of the circle of Willis in a cohort of patients with ischemic stroke. The prevalence of variants was higher in stroke patients compared to controls. Patients with variants were older but had no differences in sex, neurological admission severity, hemorrhagic transformation, etiology, and in-hospital outcome compared to patients with a typical circle of Willis.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33786665</pmid><doi>10.1007/s00415-021-10454-4</doi><tpages>9</tpages></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Etiology Fetuses Genetic transformation Hemorrhage Hypoplasia Ischemia Medicine Medicine & Public Health Neurology Neuroradiology Neurosciences Original Communication Patients Stroke |
| title | Variants of the circle of Willis in ischemic stroke patients |
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