circle of willis

Summary

Summary: A polygonal anastomosis at the base of the brain formed by the internal carotid (CAROTID ARTERY, INTERNAL), proximal parts of the anterior, middle, and posterior cerebral arteries (ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; POSTERIOR CEREBRAL ARTERY), the anterior communicating artery and the posterior communicating arteries.

Top Publications

  1. Horikoshi T, Akiyama I, Yamagata Z, Sugita M, Nukui H. Magnetic resonance angiographic evidence of sex-linked variations in the circle of willis and the occurrence of cerebral aneurysms. J Neurosurg. 2002;96:697-703 pubmed
    In this study the authors investigated the relationship between variations in the circle of Willis observed on magnetic resonance (MR) angiograms and locations of cerebral aneurysms, and evaluated the risk of aneurysm formation.
  2. Hendrikse J, Hartkamp M, Hillen B, Mali W, van der Grond J. Collateral ability of the circle of Willis in patients with unilateral internal carotid artery occlusion: border zone infarcts and clinical symptoms. Stroke. 2001;32:2768-73 pubmed
    The circle of Willis is regarded as the major source of collateral flow in patients with severe carotid artery disease...
  3. Li Q, Li J, Lv F, Li K, Luo T, Xie P. A multidetector CT angiography study of variations in the circle of Willis in a Chinese population. J Clin Neurosci. 2011;18:379-83 pubmed publisher
    The circle of Willis is a major collateral circulation that has an important role in ischemic events...
  4. Kapoor K, Singh B, Dewan L. Variations in the configuration of the circle of Willis. Anat Sci Int. 2008;83:96-106 pubmed publisher
    ..These variations are discussed with regard to development and other hemodynamic factors...
  5. Jongen J, Franke C, Ramos L, Wilmink J, van Gijn J. Direction of flow in posterior communicating artery on magnetic resonance angiography in patients with occipital lobe infarcts. Stroke. 2004;35:104-8 pubmed
    ..We studied the presence and direction of flow in the posterior communicating artery (PCoA) in patients with an occipital lobe infarct and in healthy controls...
  6. Ikeda K, Kashihara H, Hosozawa K, Shimoma M, Ichikawa Y, Igarashi O, et al. A fetal circle of Willis is associated with a decreased deep white matter lesion load. Neurology. 2005;64:2163-4; author reply 2163-4 pubmed
  7. Eldawoody H, Shimizu H, Kimura N, Saito A, Nakayama T, Takahashi A, et al. Simplified experimental cerebral aneurysm model in rats: comprehensive evaluation of induced aneurysms and arterial changes in the circle of Willis. Brain Res. 2009;1300:159-68 pubmed publisher
    ..a simplified model in rats and to provide a comprehensive evaluation of induced arterial changes in the circle of Willis. Sprague-Dawley rats underwent ligation of the right common carotid artery, and posterior and inferior (group ..
  8. Lazzaro M, Ouyang B, Chen M. The role of circle of Willis anomalies in cerebral aneurysm rupture. J Neurointerv Surg. 2012;4:22-6 pubmed publisher
    ..Cerebral aneurysms have been associated with circle of Willis anomalies but whether this association is also related to aneurysm rupture is not known...
  9. Welsh L, Welsh J, Lewin B, Dragonette J. Incompetent circle of Willis and vertebrobasilar insufficiency. Ann Otol Rhinol Laryngol. 2003;112:657-64 pubmed
    ..or more of the source vessels, the internal carotid and vertebral arteries, in conjunction with an incomplete circle of Willis increased the potential for hindbrain perfusion deficits...

More Information

Publications62

  1. Hoksbergen A, Majoie C, Hulsmans F, Legemate D. Assessment of the collateral function of the circle of Willis: three-dimensional time-of-flight MR angiography compared with transcranial color-coded duplex sonography. AJNR Am J Neuroradiol. 2003;24:456-62 pubmed
    ..We investigated the usefulness of MR angiography in identifying functional collaterals of the circle of Willis.
  2. Duelsner A, Gatzke N, Glaser J, Hillmeister P, Li M, Lee E, et al. Granulocyte colony-stimulating factor improves cerebrovascular reserve capacity by enhancing collateral growth in the circle of Willis. Cerebrovasc Dis. 2012;33:419-29 pubmed publisher
    ..We identified an effective dosing regimen that improved CVRC and stimulated collateral growth, thereby improving the outcome after experimentally induced stroke...
  3. Cucchiara B, Detre J. Migraine and circle of Willis anomalies. Med Hypotheses. 2008;70:860-5 pubmed publisher
    ..The circle of Willis is a major source of collateral blood flow supply in the human brain, and developmental morphologic variants ..
  4. Bekiesinska Figatowska M, Bragoszewska H, Duczkowski M, Romaniuk Doroszewska A, Szkudlińska Pawlak S, Duczkowska A, et al. Circle of Willis abnormalities in children with neurofibromatosis type 1. Neurol Neurochir Pol. 2014;48:15-20 pubmed publisher
    ..The aim of the study was to assess anatomical variants and abnormalities in cerebral arteries on magnetic resonance angiography in 67 children with neurofibromatosis type 1 (NF1)...
  5. Waaijer A, Prokop M, Velthuis B, Bakker C, de Kort G, van Leeuwen M. Circle of Willis at CT angiography: dose reduction and image quality--reducing tube voltage and increasing tube current settings. Radiology. 2007;242:832-9 pubmed
    To prospectively assess the effects of lower tube voltage and various effective tube currents on image quality for computed tomographic (CT) angiography of the circle of Willis.
  6. Larionov S, Dedeck O, Birkenmeier G, Thal D. Expression of alpha2-macroglobulin, neutrophil elastase, and interleukin-1alpha differs in early-stage and late-stage atherosclerotic lesions in the arteries of the circle of Willis. Acta Neuropathol. 2007;113:33-43 pubmed
    ..the proinflammatory protein interleukin-1alpha (IL-1alpha) in all types of AS plaques in the arteries of the circle of Willis from 78 human autopsy cases of both genders (61-91 years of age)...
  7. Tanaka H, Fujita N, Enoki T, Matsumoto K, Watanabe Y, Murase K, et al. Relationship between variations in the circle of Willis and flow rates in internal carotid and basilar arteries determined by means of magnetic resonance imaging with semiautomated lumen segmentation: reference data from 125 healthy volunteers. AJNR Am J Neuroradiol. 2006;27:1770-5 pubmed
    ..Although these flow values are thought to be effected by anatomic variations in the circle of Willis, few reports have described the effect...
  8. van Kooij B, Hendrikse J, Benders M, de Vries L, Groenendaal F. Anatomy of the circle of Willis and blood flow in the brain-feeding vasculature in prematurely born infants. Neonatology. 2010;97:235-41 pubmed publisher
    ..Previous studies have shown a disrupted development of cerebral blood vessels at term-equivalent age in prematurely born infants...
  9. Hendrikse J, van Raamt A, van der Graaf Y, Mali W, van der Grond J. Distribution of cerebral blood flow in the circle of Willis. Radiology. 2005;235:184-9 pubmed
    To prospectively determine the effect of anatomic variations in the circle of Willis on volume flow in the internal carotid arteries (ICAs) and basilar artery (BA).
  10. van der Grond J, van Raamt A, van der Graaf Y, Mali W, Bisschops R. A fetal circle of Willis is associated with a decreased deep white matter lesion load. Neurology. 2004;63:1452-6 pubmed
    To investigate the relationship between morphologic differences in the circle of Willis and the presence and location of white matter lesions (WMLs).
  11. Han A, Yoon D, Chang S, Lim K, Cho B, Shin Y, et al. Accuracy of CT angiography in the assessment of the circle of Willis: comparison of volume-rendered images and digital subtraction angiography. Acta Radiol. 2011;52:889-93 pubmed publisher
    ..Computed tomography angiography (CTA) is increasingly used for non-invasive imaging of the cerebrovascular diseases...
  12. Pistocchi S, Blanc R, Bartolini B, Piotin M. Flow diverters at and beyond the level of the circle of willis for the treatment of intracranial aneurysms. Stroke. 2012;43:1032-8 pubmed publisher
    ..Initial reports focused on the treatment of proximally located aneurysms. We report our experience with FDs in the treatment of aneurysms at and beyond the circle of Willis.
  13. Busch H, Buschmann I, Mies G, Bode C, Hossmann K. Arteriogenesis in hypoperfused rat brain. J Cereb Blood Flow Metab. 2003;23:621-8 pubmed
    ..Three-vessel occlusion is a reliable model for the induction of arteriogenesis in the adult brain and is a new approach for exploring the potentials of arteriogenesis for the prevention of progressing brain ischemia...
  14. Cucchiara B, Wolf R, Nagae L, Zhang Q, Kasner S, Datta R, et al. Migraine with aura is associated with an incomplete circle of willis: results of a prospective observational study. PLoS ONE. 2013;8:e71007 pubmed publisher
    To compare the prevalence of an incomplete circle of Willis in patients with migraine with aura, migraine without aura, and control subjects, and correlate circle of Willis variations with alterations in cerebral perfusion.
  15. Tayebati S, Di Tullio M, Tomassoni D, Amenta F. Localization of the m5 muscarinic cholinergic receptor in rat circle of Willis and pial arteries. Neuroscience. 2003;122:205-11 pubmed
    ..and microanatomical localization of the muscarinic cholinergic m5 receptor subtype was investigated in rat circle of Willis and pial arteries by in situ hybridization, immunoblotting and immunohistochemistry...
  16. Kelly M, Turner R, Gonugunta V, Woo H, Rasmussen P, Masaryk T, et al. Stent reconstruction of wide-necked aneurysms across the circle of Willis. Neurosurgery. 2007;61:249-54; discussion 254-5 pubmed publisher
    To describe a novel technique for single stent reconstruction of wide-necked aneurysms arising from the circle of Willis.
  17. Kablak Ziembicka A, Przewlocki T, Pieniazek P, Musialek P, Motyl R, Moczulski Z, et al. Assessment of flow changes in the circle of Willis after stenting for severe internal carotid artery stenosis. J Endovasc Ther. 2006;13:205-13 pubmed
    ..To assess flow velocities in the cerebral arteries after carotid artery stenting (CAS) in patients with unilateral versus bilateral lesions and analyze velocities in patients with neurological complications after CAS...
  18. de Rooij N, Velthuis B, Algra A, Rinkel G. Configuration of the circle of Willis, direction of flow, and shape of the aneurysm as risk factors for rupture of intracranial aneurysms. J Neurol. 2009;256:45-50 pubmed publisher
    ..We studied whether configuration of the circle of Willis, direction of flow towards the aneurysm, and shape of the aneurysm are risk factors for rupture.
  19. Chuang Y, Liu C, Pan P, Lin C. Posterior communicating artery hypoplasia as a risk factor for acute ischemic stroke in the absence of carotid artery occlusion. J Clin Neurosci. 2008;15:1376-81 pubmed publisher
    Posterior communicating artery (PCoA) hypoplasia is a fetal variant of the Circle of Willis. According to angiograms and autopsy reports, this congenital variation is found in 6-21% of the general population...
  20. Merkkola P, Tulla H, Ronkainen A, Soppi V, Oksala A, Koivisto T, et al. Incomplete circle of Willis and right axillary artery perfusion. Ann Thorac Surg. 2006;82:74-9 pubmed
    ..We considered that critical arteries to examine are anterior and left posterior communicating arteries of the circle of Willis because the absence or insufficiency of either one would drastically endanger perfusion to the left ..
  21. Fontanella M, Valfrè W, Benech F, Carlino C, Garbossa D, Ferrio M, et al. Vasospasm after SAH due to aneurysm rupture of the anterior circle of Willis: value of TCD monitoring. Neurol Res. 2008;30:256-61 pubmed
    ..The aim of this study was to verify the presence of angiographic vasospasm in patients with transcranial Doppler (TCD) of high velocities after subarachnoid hemorrhage (SAH)...
  22. Chuang Y, Chan L, Lai Y, Kuo K, Chiou Y, Huang L, et al. Configuration of the circle of Willis is associated with less symptomatic intracerebral hemorrhage in ischemic stroke patients treated with intravenous thrombolysis. J Crit Care. 2013;28:166-72 pubmed publisher
    The circle of Willis (CoW) is a primary collateral pathway that compensates quickly for a drop in cerebral blood flow...
  23. Bugnicourt J, Garcia P, Peltier J, Bonnaire B, Picard C, Godefroy O. Incomplete posterior circle of willis: a risk factor for migraine?. Headache. 2009;49:879-86 pubmed
    ..hypoperfusion is known to be one mechanism underlying WMA and a few studies have shown that an incomplete circle of Willis (CW) may predispose to cerebral hypoperfusion...
  24. Cavestro C, Richetta L, L episcopo M, Pedemonte E, Duca S, Di Pietrantonj C. Anatomical variants of the circle of willis and brain lesions in migraineurs. Can J Neurol Sci. 2011;38:494-9 pubmed
    ..vascular alterations in brain magnetic resonance imaging (MRI) in migraineurs and a relationship between circle of Willis (Circle) variants and lacunar brain infarcts...
  25. Grinberg L, Cheever E, Anor T, Madsen J, Karniadakis G. Modeling blood flow circulation in intracranial arterial networks: a comparative 3D/1D simulation study. Ann Biomed Eng. 2011;39:297-309 pubmed publisher
    ..Sensitivity of the flow and pressure with respect to variation in the elasticity parameters is investigated with the 1D model...
  26. Moore S, Moorhead K, Chase J, David T, Fink J. One-dimensional and three-dimensional models of cerebrovascular flow. J Biomech Eng. 2005;127:440-9 pubmed
    The Circle of Willis is a ring-like structure of blood vessels found beneath the hypothalamus at the base of the brain. Its main function is to distribute oxygen-rich arterial blood to the cerebral mass...
  27. Arat A, Cil B. Double-balloon remodeling of wide-necked aneurysms distal to the circle of Willis. AJNR Am J Neuroradiol. 2005;26:1768-71 pubmed
    ..two compliant balloon catheters were used to treat large, wide-necked bifurcation aneurysms distal to the circle of Willis in two patients with subarachnoid hemorrhage...
  28. Mulder G, Bogaerds A, Rongen P, van de Vosse F. The influence of contrast agent injection on physiological flow in the circle of Willis. Med Eng Phys. 2011;33:195-203 pubmed publisher
    ..cycle, the response does vary with the location within the cerebral circulation and the geometry of the circle of Willis. At the injection site, the injection partly suppresses the incoming blood flow, such that the distal flow is ..
  29. Paemeleire K, Proot P, De Keyzer K, Achten E, Crevits L. Magnetic resonance angiography of the circle of Willis in migraine patients. Clin Neurol Neurosurg. 2005;107:301-5 pubmed
    ..presented at our neurological polyclinic between 1996 and 2001 with migraine and who underwent a MRA of the circle of Willis. In 80 cases, a definitive migraine diagnosis according to the International Headache Society criteria (1988) ..
  30. Lee J, Choi C, Kim D, Kim G, Lee H, Suh D. Relationship between circle of Willis morphology on 3D time-of-flight MR angiograms and transient ischemia during vascular clamping of the internal carotid artery during carotid endarterectomy. AJNR Am J Neuroradiol. 2004;25:558-64 pubmed
    ..We investigated whether circle of Willis morphology on 3D time-of-flight (TOF) MR angiograms can reliably predict transient ischemia during vascular ..
  31. Meyer R, Nickerson J, Burbank H, Alsofrom G, Linnell G, Filippi C. Discrepancy rates of on-call radiology residents' interpretations of CT angiography studies of the neck and circle of Willis. AJR Am J Roentgenol. 2009;193:527-32 pubmed publisher
    The purpose of our study was to determine the discrepancy rates of radiology residents' interpretations of emergent CT angiography (CTA) studies of the neck and circle of Willis and to assess any adverse clinical outcomes.
  32. van Raamt A, Mali W, van Laar P, van der Graaf Y. The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation. Cerebrovasc Dis. 2006;22:217-24 pubmed
    In a fetal-type posterior circle of Willis (FTP) there is an embryonic derivation of the posterior cerebral artery (PCA) from the internal carotid artery (ICA)...
  33. Roher A, Esh C, Kokjohn T, Kalback W, Luehrs D, Seward J, et al. Circle of willis atherosclerosis is a risk factor for sporadic Alzheimer's disease. Arterioscler Thromb Vasc Biol. 2003;23:2055-62 pubmed
    ..We conducted a quantitative investigation of brain arterial atherosclerotic damage and its relationship to sporadic Alzheimer's disease (AD)...
  34. Liang F, Fukasaku K, Liu H, Takagi S. A computational model study of the influence of the anatomy of the circle of willis on cerebral hyperperfusion following carotid artery surgery. Biomed Eng Online. 2011;10:84 pubmed publisher
    ..The purpose of this study is to investigate whether and how the anatomy of the Circle of Willis (CoW) of the cerebral circulation influences post-CAS cerebral hyperperfusion.
  35. Larionov S, Dedeck O, Birkenmeier G, Orantes M, Ghebremedhin E, Thal D. The intronic deletion polymorphism of the Alpha2- macroglobulin gene modulates the severity and extent of atherosclerosis in the circle of Willis. Neuropathol Appl Neurobiol. 2006;32:451-4 pubmed
  36. Hoksbergen A, Legemate D, Csiba L, Csáti G, Síró P, Fulesdi B. Absent collateral function of the circle of Willis as risk factor for ischemic stroke. Cerebrovasc Dis. 2003;16:191-8 pubmed
    Autopsy studies show a higher prevalence of circle of Willis anomalies in brains with signs of ischemic infarction...
  37. Nakamura K, Yanaka K, Ihara S, Nose T. Multiple intracranial arterial stenoses around the circle of Willis in association with Graves' disease: report of two cases. Neurosurgery. 2003;53:1210-4; discussion 1214-5 pubmed
    ..The association of Graves' disease with multiple intracranial arterial stenoses is rare...
  38. Kapoor K, Kak V, Singh B. Morphology and comparative anatomy of circulus arteriosus cerebri in mammals. Anat Histol Embryol. 2003;32:347-55 pubmed
    ..In rhesus monkeys, dogs and rabbits, the circle of Willis is almost similar to that in human beings except that in these animals, (i) the anterior cerebral arteries ..
  39. Stojanović N, Stefanovic I, Randjelović S, Mitić R, Bosnjakovic P, Stojanov D. Presence of anatomical variations of the circle of Willis in patients undergoing surgical treatment for ruptured intracranial aneurysms. Vojnosanit Pregl. 2009;66:711-7 pubmed
    ..This study investigated the relation between ruptured aneurysms and anatomical configuration of the Circle of Willis, with the purpose to obtain an insight into their mutual connection.
  40. Maltezos C, Papanas N, Papas T, Georgiadis G, Dragoumanis C, Marakis J, et al. Changes in blood flow of anterior and middle cerebral arteries following carotid endarterectomy: a transcranial Doppler study. Vasc Endovascular Surg. 2007;41:389-96 pubmed
    ..The aim of the present study was to evaluate the changes in blood flow of anterior and middle cerebral arteries following carotid endarterectomy, using transcranial Doppler (TCD) flow studies...
  41. Proust F, Debono B, Gerardin E, Hannequin D, Derrey S, Langlois O, et al. Angiographic cerebral vasospasm and delayed ischemic deficit on anterior part of the circle of Willis. Usefulness of transcranial Doppler. Neurochirurgie. 2002;48:489-99 pubmed
    ..The aims of the study were, on a prospectively collected series of 460 patients, to assess angiographic VS incidence, to determine possible risk factors, and to evaluate diagnostic sensitivity and specificity of TCD...
  42. Vasovic L, Milenkovic Z, Pavlovic S. Comparative morphological variations and abnormalities of circles of Willis: a minireview including two personal cases. Neurosurg Rev. 2002;25:247-51 pubmed
    Two rare cases of the circle of Willis are presented. One of them represents a fetal circle of Willis (crown-rump length, or CRL, 17 cm), the other one is adult circle from a male cadaver 65 years of age...
  43. Hofmeijer J, Klijn C, Kappelle L, van Huffelen A, van Gijn J. Collateral circulation via the ophthalmic artery or leptomeningeal vessels is associated with impaired cerebral vasoreactivity in patients with symptomatic carotid artery occlusion. Cerebrovasc Dis. 2002;14:22-6 pubmed
    ..been considered secondary collaterals, which are recruited only if the primary collateral circulation via the circle of Willis is insufficient...
  44. van Osch M, Hendrikse J, Golay X, Bakker C, van der Grond J. Non-invasive visualization of collateral blood flow patterns of the circle of Willis by dynamic MR angiography. Med Image Anal. 2006;10:59-70 pubmed
    The circle of Willis plays an important role in the distribution of blood flow in the brain...
  45. Orosz L, Hoksbergen A, Molnár C, Síró P, Cassot F, Marc Vergnes J, et al. Clinical applicability of a mathematical model in assessing the functional ability of the communicating arteries of the circle of Willis. J Neurol Sci. 2009;287:94-9 pubmed publisher
    ..We compared data obtained from transcranial color-coded duplex sonography (TCCD) combined with carotid compression tests to morphometric autopsy data and to results given by a mathematical model of the cerebral macrocirculation...
  46. Malamateniou C, Adams M, Srinivasan L, Allsop J, Counsell S, Cowan F, et al. The anatomic variations of the circle of Willis in preterm-at-term and term-born infants: an MR angiography study at 3T. AJNR Am J Neuroradiol. 2009;30:1955-62 pubmed publisher
    ..Our aims were to establish reference data for the prevalence of the anatomic variations of the neonatal circle of Willis (CoW) and to explore the effect of prematurity, MR imaging abnormality, vascular-related abnormality, ..
  47. Beach T, Wilson J, Sue L, Newell A, Poston M, Cisneros R, et al. Circle of Willis atherosclerosis: association with Alzheimer's disease, neuritic plaques and neurofibrillary tangles. Acta Neuropathol. 2007;113:13-21 pubmed
    ..by three independent groups have found a significant statistical association between postmortem measures of circle of Willis atherosclerosis and AD...
  48. Alastruey J, Parker K, Peiro J, Byrd S, Sherwin S. Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows. J Biomech. 2007;40:1794-805 pubmed
    Blood flow in the circle of Willis (CoW) is modelled using the 1-D equations of pressure and flow wave propagation in compliant vessels. The model starts at the left ventricle and includes the largest arteries that supply the CoW...
  49. Kumar N, Lee J, Perlmutter J, Derdeyn C. Cervical carotid and circle of willis arterial anatomy of macaque monkeys: a comparative anatomy study. Anat Rec (Hoboken). 2009;292:976-84 pubmed publisher
    ..The ICA is similar in course to that of the human. The anterior circle of Willis was intact in all monkeys in our study...
  50. Eftekhar B, Dadmehr M, Ansari S, Ghodsi M, Nazparvar B, Ketabchi E. Are the distributions of variations of circle of Willis different in different populations? - Results of an anatomical study and review of literature. BMC Neurol. 2006;6:22 pubmed
    Previous studies have proposed correlation between variants of the cerebral arterial circle (also known as circle of Willis) and some cerebrovascular diseases...
  51. Rhoton A. The supratentorial arteries. Neurosurgery. 2002;51:S53-120 pubmed
  52. Waaijer A, van Leeuwen M, van der Worp H, Verhagen H, Mali W, Velthuis B. Anatomic variations in the circle of Willis in patients with symptomatic carotid artery stenosis assessed with multidetector row CT angiography. Cerebrovasc Dis. 2007;23:267-74 pubmed
    To assess the presence of anterior and posterior collateral pathways in the circle of Willis in patients with symptomatic carotid artery stenosis (SCAS) and to compare this to patients without carotid artery stenosis.
  53. Papantchev V, Hristov S, Todorova D, Naydenov E, Paloff A, Nikolov D, et al. Some variations of the circle of Willis, important for cerebral protection in aortic surgery--a study in Eastern Europeans. Eur J Cardiothorac Surg. 2007;31:982-9 pubmed
    ..For perfusion of the contralateral (left) hemisphere it is counted on the competence of the circle of Willis (CoW). It is well known that variations of CoW are present in more than 50% of the people...