Classification of Anatomical Variations of the Circle of Willis in the Pediatric Age Group
Öz
Objective: The Circle of Willis (CoW) is a vascular ring formed by the anastomosis of branches from the internal carotid and vertebral arteries at the base of the brain. Anatomic variations of the CoW are common and may influence cerebrovascular dynamics. This study aims to provide reference data on the diameters, morphology, and anatomic variations of the arteries forming the CoW in pediatric patients.
Materials and Methods: In this retrospective study, contrast-enhanced cranial magnetic resonance imaging scans of 110 pediatric patients were analyzed. The study population was divided into three age groups (0–3, 3–12, and 12–18 years). The diameters of the arterial components of the CoW were measured; arteries with a diameter of < 1 mm were defined as hypoplastic, and complete absence was considered as aplasia. Structure was classified as complete or incomplete, while additional anatomic variants were recorded separately. The anterior communicating artery (AComA) was evaluated only as present or absent (aplastic) due to its small size in pediatric populations.
Results: A complete CoW configuration was observed in 48.2% of cases, with the highest prevalence (52.8%) in the 12-18 year group. AComA aplasia and left posterior communicating arteries (PComA) aplasia were the most common variations. Other variations included duplicated right and left posterior communicating arteries, a fenestrated right posterior cerebral artery, and a common trunk giving rise to both right and left anterior cerebral arteries.
Conclusion: This study provides valuable reference data on the CoW variations in pediatric patients, which are essential for safer cerebrovascular operations and informed clinical decision-making.
Anahtar Kelimeler
Proje Numarası
Kaynakça
- Jones JD, Castanho P, Bazira P, Sanders K. Anatomical variations of the Circle of Willis and their prevalence, with a focus on the posterior communicating artery: A literature review and meta-analysis. Clin Anat 2021;34(7):978-90. google scholar
- Karatas A, Yilmaz H, Coban G, Koker M, Uz A. The anatomy of circulus arteriosus cerebri (Circle of Willis): A study in Turkish population. Turk Neurosurg 2016;26(1):54-61. google scholar
- Arinci K, Elhan A, editors. Anatomi. 7th ed. Ankara: Gunes Tip Kitabevleri; 2020. p.38. google scholar
- Ayre JR, Bazira PJ, Abumattar M, Makwana HN, Sanders KA. A new classification system for the anatomical variations of the human Circle of Willis: a systematic review. J Anat 2021;240(6):1187-1204. google scholar
- Bisschops RHC, Klijn CJM, Kappelle LJ, Van Huffelen AC, Van der Grond J. Collateral flow and ischemic brain lesions in patients with unilateral carotid artery occlusion. Neurology 2003;60(9):1435-41. google scholar
- Ren Y, Chen Q, Li ZY. A 3D numerical study of the collateral capacity of the Circle of Willis with anatomical variation in the posterior circulation. Biomed Eng Online 2015;14:1-12. google scholar
- Solak S, Ustabasioğlu FE, Alkan A, Kula O. Anatomical variations of the Circle of Willis in children. Pediatr Radiol 2021;51:2581-87. google scholar
- Osborn AG. Diagnostic Cerebral Angiography. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1999. google scholar
Ayrıntılar
Birincil Dil
İngilizce
Konular
Beyin ve Sinir Cerrahisi (Nöroşirurji), Radyoloji ve Organ Görüntüleme, Klinik Tıp Bilimleri (Diğer)
Bölüm
Araştırma Makalesi
Yazarlar
Umut Şener
0000-0003-1815-9346
Türkiye
Yayımlanma Tarihi
14 Ağustos 2026
Gönderilme Tarihi
8 Ekim 2025
Kabul Tarihi
4 Haziran 2026
Yayımlandığı Sayı
Yıl 2026 Cilt: 89 Sayı: 3