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1.
001-es BibID:
BIBFORM057003
Első szerző:
Hoksbergen, Arjan W. J.
Cím:
Absent Collateral Function of the Circle of Willis as Risk Factor for Ischemic Stroke / A. W. J. Hoksbergen, D. A. Legemate, L. Csiba, G. Csati, P. Siro, B. Fulesdi
Dátum:
2003
ISSN:
1015-9770
Megjegyzések:
Background: Autopsy studies show a higher prevalence of circle of Willis anomalies in brains with signs of ischemic infarction. Our goal was to examine the collateral function of the circle of Willis in ischemic stroke patients and to assess in a case-control study if a collateral deficient circle of Willis is a risk factor for ischemic stroke in patients with severe internal carotid artery (ICA) occlusive disease. Methods: Our case-control study included 109 patients with an acute ischemic stroke in the anterior circulation and 113 patients with peripheral arterial disease and no known history of cerebral ischemia. The collateral function of the anterior and posterior communicating arteries of the circle of Willis was assessed by means of transcranial color-coded duplex ultrasonography (TCCD) and carotid compression tests. Results: TCCD was successfully performed in 75 case patients (mean age 64 years, range 41-91 years) and in 100 control patients (mean age 61 years, range 35-89 years). In 26 cases and 19 controls, a ? 70% stenosis or occlusion of the ICA was found. A nonfunctional anterior collateral pathway in the circle of Willis was found in 33% of the cases and in 6% of the controls (p < 0.001). The posterior collateral pathway was nonfunctional in 57% of the cases and in 43% of the controls (p = 0.02). In patients with severe ICA occlusive disease, the odds ratios of a nonfunctional anterior and a nonfunctional posterior collateral pathway were 7.33 (95% confidence interval, CI, = 1.19-76.52) and 3.00 (95% CI = 0.77-12.04), respectively. Conclusions: Patients who suffer ischemic stroke in the anterior circulation have a higher incidence of collateral deficient circles of Willis than those with atherosclerotic vascular disease without ischemic cerebrovascular disease. The presence of a nonfunctional anterior collateral pathway in the circle of Willis in patients with severe ICA occlusive disease is strongly associated with ischemic stroke.
Tárgyszavak:
Orvostudományok
Klinikai orvostudományok
idegen nyelvű folyóiratközlemény külföldi lapban
Cerebral ischemia
Circle of Willis
Collateral circulation
Transcranial ultrasound
Megjelenés:
Cerebrovascular Diseases. - 16 : 3 (2003), p. 191-198. -
További szerzők:
Legemate, D.
Csiba László (1952-) (neurológus, pszichiáter)
Csáti Géza
Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos)
Fülesdi Béla (1961-) (aneszteziológus)
Internet cím:
Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:
Saját polcon:
2.
001-es BibID:
BIBFORM038845
Első szerző:
Hoksbergen, Arjan W. J.
Cím:
Collateral configuration of the circle of Willis : transcranial colo r-coded duplex ultrasonography and comparison with postmortem anatomy / Hoksbergen, A. W. J., Fulesdi, B., Legemate, D. A., Csiba, L.
Dátum:
2000
ISSN:
0039-2499
Megjegyzések:
The anterior communicating artery (AcoA) and posterior communicating arteries (PcoA) of the circle of Willis provide the main route for collateral blood flow in cases of carotid artery obstruction. Transcranial color-coded duplex ultrasonography (TCCD) allows real-time measurement of the collateral function of the AcoA and PcoA. The primary objective of this study was to determine the collateral artery threshold diameters for supplying collateral flow. METHODS: In 12 acute stroke patients with a median age of 75 years (51 to 91 years), the collateral integrity of the circle of Willis as assessed by TCCD and carotid compression tests was compared with their postmortem anatomy. The lengths and diameters of the collateral arteries were measured. RESULTS: TCCD demonstrated absent anterior collateral flow in 3 patients. In 1 of these patients, absence of anterior cross-flow was due to an occluded anterior cerebral artery, which was revealed at autopsy. Absent posterior collateral flow was found in 14 hemispheres. In 2 of these hemispheres, autopsy revealed a fetal configuration of the posterior cerebral artery hampering posterior collateral flow. The median (range) diameters as found at autopsy of the functional (n=19) and nonfunctional (n=16) collateral arteries of the circle of Willis were 1.1 (0.4 to 2.0) and 0.5 (0.3 to 0.7) mm, respectively (P=0.003). PcoA diameters were found to correlate negatively (rho=-0. 50, P=0.01) to the diameters of their accessory P1 segments. CONCLUSIONS: The threshold diameter allowing for cross-flow through the primary collateral arteries of the circle of Willis is between 0. 4 and 0.6 mm.
Tárgyszavak:
Orvostudományok
Klinikai orvostudományok
idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:
Stroke. - 31 : 6 (2000), p. 1346-1351. -
További szerzők:
Fülesdi Béla (1961-) (aneszteziológus)
Legemate, D.
Csiba László (1952-) (neurológus, pszichiáter)
Internet cím:
Intézményi repozitóriumban (DEA) tárolt változat
DOI
Borító:
Saját polcon:
3.
001-es BibID:
BIBFORM105018
035-os BibID:
(WOS)000879996500001 (Scopus)85142129652
Első szerző:
Orosz László (sebész)
Cím:
Assessment of malformations, variations and diameters of vessels forming the circle of Willis : An autopsy study in a non-cerebrovascular cohort / Orosz László, Gyöngyösi Zoltán, Susán Zsolt, Siró Péter, Hoksbergen Arjan Willem, Csiba László, Fülesdi Béla
Dátum:
2022
ISSN:
2081-3856 2081-6936
Megjegyzések:
Background a purpose The collateral capacity of the circle of Willis (CoW) may play an important role in the development of ischemic strokes. The occurrence of classical polygon shows wide geographical variations and morphological data on diameters of the Willisian collaterals are scarce. We aimed to assess CoW variations and vessel diameters in a Central European cohort. Subjects and methods CoWs were removed during routine autopsy. The morphological pattern of the circles was recorded. The prepared circles were then put between two glass plates and tightly compressed. The length of the vessels and half of the circumference were measured under a light microscope enabling measurement with an approximation of 0.1?mm. Vessel diameters were calculated from vessel circumference. Results A total of 110 circles were analysed. Incomplete circles (missing one or two segments of CoW) were found in 25 cases (22.7%). Any forms of anatomical variations were detected in 14 cases (12.7%). When applying the <1?mm diameter threshold for analysis, 36 anterior communicating arteries (32.7%), 53 right posterior communicating arteries (48.2%), 73 left posterior communicating arteries (66.4%) and 18 posterior communicating arteries (16.3%) on both the sides were considered hypoplastic. Conclusions In patients without stroke in their history, complete CoW may be present in >60% of the cases. Our diameter data may serve as reference values for the Central-European population.
Tárgyszavak:
Orvostudományok
Klinikai orvostudományok
idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:
Translational Neuroscience. - 13 : 1 (2022), p. 398-406. -
További szerzők:
Gyöngyösi Zoltán (1977-) (aneszteziológus)
Susán Zsolt (1983-) (sebész)
Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos)
Hoksbergen, Arjan W. J.
Csiba László (1952-) (neurológus, pszichiáter)
Fülesdi Béla (1961-) (aneszteziológus)
Internet cím:
Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
Borító:
Saját polcon:
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