Variant of development of Willis circle of the brain

In the recognition of arterial pathology of the base of the brain, visual (neurological and ophthalmic) examination is not enough.

Therefore, they resort to instrumental examination of blood vessels by methods:

  • ultrasound dopplerography;
  • MRI (magnetic resonance imaging);
  • radiopaque angiography;
  • transcranial dopplerography;
  • magnetic resonance angiography;
  • selective angiography.

Since VK performs mainly a reserve mission, minor design errors may not bother a person with negative symptoms until the moment when activation of his compensatory functions is required.

The need to include elements of the Willis circle in the work is formed under circumstances when blood flow insolvency develops along ring paths for various reasons. Symptoms of an abnormal variant of VK development can be triggered by pinching of the vascular bed, appearing against the background of the formation of blood clots or lipid blockages in the arteries that saturate the brain, with aneurysms or their rupture. Such precedents provoke the need to include “workarounds” for the delivery of blood to the deficient areas of the brain.

Symptoms of insufficient blood supply to the hemispheres can be of a diverse nature. The most popular signs of the non-classical variant of the development of the Willis circle are systematic manifestations of migraine, dizziness, and a deterioration in the competencies of the thinking class, memory, and mindfulness. The pathological structure of VK can also be expressed by problems of a neurological nature in the form of panic attacks, emotional instability, or a tendency to neurosis.

In situations where the abnormal configuration of the Willis circle caused serious blood flow disorders, pathology can be expressed by the symptoms of a stroke with possible paralysis, paresis, impaired consciousness, fainting, and other symptoms characteristic of this disease.

Enlargements of the cerebral vessels, called aneurysms, are most often formed in segments of the Willis ring trunks against the background of its modification of the non-classical type. In such situations, precedents of hemorrhages in the subarachnoid zone of the brain are possible when the integrity of the aneurysm is damaged, which in medicine is considered a hemorrhagic stroke, dangerous for its consequences.

The abnormal structure of the VC can be determined by modern hardware techniques that allow us to study the structure and structure of the vascular highways of the brain.

The following studies are considered to be the main diagnostic procedures:

  1. Magnetic resonance imaging or computed tomography. Both methods are non-contact, they provide informative data on the state of cerebral vascular branches. The first method is considered the safest for health, however, it refers to expensive diagnostics, CT is more affordable financially, and is performed by X-ray irradiation, which can be called a “conditionally safe” process for health.
  2. Angiography is a methodology that allows you to obtain information about the state of the blood channels after direct injection of contrast medium into the vessel. Angiography refers to invasive diagnostics, therefore it can have contraindications or lead to certain complications. Such a study is less modern than previous methodologies, while authorizing the assessment of the condition and patency of highways.
  3. Dopplerographic examination of the hemispheres is carried out by passing ultrasonic waves through the human brain, which is an absolutely safe process for health. This method has many advantages, as it allows not only to identify the abnormal configuration of blood vessels, but also to determine the presence of pathological deformations of the channels, their localization, to evaluate the speed and direction of blood flow.

It is important to understand that the verdict from the doctor “an unconventional variant of VK development” is not a reason for panic and the start of treatment. Certain inconsistencies in the construction of the vascular ring do not require compulsory therapy, treatment is prescribed only in situations where an incorrect configuration of the arteries is unsafe for health and provokes a deterioration in the blood supply to the brain.

The need for treatment and its specificity is decided exclusively by a qualified specialist and only on the basis of the results of hardware diagnostics. To clarify the diagnosis, you may need several ways to diagnose the problem.

What in practice mean various options for the structure of VC?

The Willis circle is the very beginning of the entire circulatory network, rising from the base of the brain upward both on its surface and in the bowels, so that further, endlessly branching, reach each individual cell in its tissues and structures.

And power outages can occur due to the appearance in one of the arterial branches:

  • spasm;
  • narrowing of the lumen of another etiology (due to the formation of cholesterol deposits, a blood clot, thickening of the wall from scar formation, due to clamping from the outside);
  • aneurysmal deformity of the lumen;
  • atrophy or desolation (subsidence with a clearance of the lumen – obliteration).

Or it may be a consequence of hypoplasia (congenital underdevelopment), which affected at a critical moment.

For most people, the non-standard formation of VK is a physiological standard and may not bother a person throughout his life. Health problems, due to the pathological structure of the ring, are manifested in situations where, against the background of unfavorable factors of the channel of the ring formation, they undergo deformations, which is reflected in the deterioration of blood flow.

Such precedents previously occurred mainly in old age, as a result of the aging process of the body, which was expressed in parallel with a decrease in the elasticity and tone of the vessels. At present, the development of the Willis circle in the form of a decrease in blood flow is characteristic of people of the younger generation as a result of negative provocateurs of a social or subjective nature.

Nonspecific versions of the VK design can provoke the progression of life-threatening problems in the head, when compensatory possibilities decrease against the background of critical changes in blood circulation in the vascular trunks of the hemispheres.

Among the most popular pathologies that are life-threatening and often found in medical practice, medicine distinguishes:

  1. Aneurysms.
  2. Strokes of an ischemic nature.

Aneurysm in medicine is called deformation of the vessel, accompanied by a protrusion of the membrane against the background of a thinning of its surface cover. The vessels of the VK ring are considered the most prone to the appearance of aneurysms with non-standard variants of its design. With a small scale of formation, the patient may not feel any negative symptoms, however, an enlargement of the protrusion can provoke an infringement of the central nervous system tissues, which will be expressed by the following symptoms:

  1. Deterioration of vision.
  2. The occurrence of intense headaches, turning into regular migraines.

If you do not seek medical help in time and find a problem at this stage, aneurysm rupture may follow, which is a direct threat to the patient’s life. The following symptoms will indicate a rupture of the aneurysm:

  1. Intense, piercing pain in the head.
  2. Nausea with bouts of vomiting.
  3. Stiff feeling in the cervical spine.
  4. Short-term loss of consciousness or vision.

Often the provocateur of the progression of an ischemic stroke is the presence of VK breaks or the asymmetric structure of its structure. In the presence of additional negative factors, collateral blood flow worsens, and VK cannot provide adequate compensatory blood supply to the hemispheres. As a result, certain parts of the brain begin to experience a deficiency of blood, and with it oxygen and beneficial components, resulting in the death of tissues in the hemispheres.

The most common symptoms of a precedent are the following symptoms:

  1. Unexpected numbness of half the body or weakness in muscle tissue.
  2. Rapid degradation of consciousness, distortion of speech.
  3. Loss of motor coordination.
  4. Rapid increase in headache.

Such symptoms are a harbinger of a stroke, requiring urgent hospitalization of the patient in a medical facility.

Why is improper development dangerous?

Congenital abnormalities can gradually create difficulty in blood supply or signs of decompensation with an excessive load on the arteries.

The consequences can be catastrophic at all – the development of aneurysm, hemorrhagic or ischemic strokes.

Even in young people, there may be a periodic appearance of migraine attacks.

In the older age category, aneurysms provoked by acquired pathologies (atherosclerosis, vasculitis infections, syphilis) are more likely to occur.

Aneurysm – a protrusion on the wall of the artery, the development of pathology proceeds without visible symptoms. It is most often localized inside the Willis circle (in the PSA or ZSA, on the bifurcation of the ICA and BA) against the background of the asymmetric structure of the arterial ring.

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With the formation of aneurysm, there is a danger of rupture of the vessel and, as a result, hemorrhage in the brain.

Clinical syndromes caused by aneurysms of the arterial ring:

  • pseudotumorous – nerve tissues and medulla are compressed;
  • hemorrhagic extracerebral basal – after rupture of a vessel with subarachnoid hemorrhage;
  • discirculatory – with slow growth or with the development of an exfoliating form of aneurysm.

Anomalies of branching options and deformation of the form (broken circle) weaken or lead to loss of compensation in complex cases (hypertensive crisis, thrombophlebitis, spasm, etc.).

The specificity and need for treatment of different types of VK configuration

The non-standard development of the Willis circle revealed as a result of a situational examination of the body often does not require urgent hospitalization of the patient or targeted therapy. If a person is not concerned about negative manifestations, then doctors will recommend him exclusively preventive measures that are aimed at reducing the risk of thrombosis and atherosclerosis of blood vessels.

Prevention of these diseases often consists in eliminating negative factors of a social and subjective nature, which include refusal from addictions, rationalization of nutrition, conducting active life activities, and avoiding stressful situations. In addition, the patient, after identifying the non-standard formation of the Willis ring, should pay more attention to his health, regularly undergo medical examinations so as not to miss the possible development of complications and take urgent measures to eliminate them.

Treatment is provided exclusively in cases where the state of the VC vessels is critical for the patient’s life, mainly with aneurysms. If there is an aneurysm, the patient will have surgery: surgery to remove the formation, which is carried out by trepanation of the skull, or the installation of a special spiral in a damaged vessel under local anesthesia, if the aneurysm has not reached critical dimensions in its parameters.

Symptoms of the appearance of diseases

The open Willis circle, unlike other GM arteries, is not balanced by the pressure of the brain tissue.

This may cause the following symptoms:

  • often dizzy;
  • with a sharp turn of the body there are unpleasant sensations;
  • severe headache, which does not help painkillers;
  • migraine attacks, accompanied by nausea, sometimes vomiting, photo and phonophobia.

Symptoms of aneurysms of the open arterial ring depend on the location, size and nature of the pathology, which in most cases affect the nervous system.

With aneurysm compression of the surrounding nerve tissue, the clinical picture is composed of the following symptoms:

  • doubles in eyes;
  • pupils dilated;
  • soreness in the inner part of the orbit of the eyeballs;
  • headache.

With aneurysms of PSA (anterior connective artery), visual impairment and smell are added.

If the arterial circle is not closed, then when the aneurysm ruptures, spontaneous sensations appear:

  • heaviness in the head;
  • nausea accompanied by vomiting;
  • stiffness in the cervical spine;
  • temporary loss of vision or unconsciousness.

Anomalies of the open arterial circle increase the risk of developing ischemic stroke, which is accompanied by sudden manifestations:

  • muscle weakness or numbness on one side of the body;
  • confusion;
  • impaired speech and vision;
  • staggering gait;
  • dizziness;
  • uncoordination of movements;
  • cephalgia.

Conclusion

The verdict of doctors that the vascular arteries of the Willis circle have an irregular structure is not always a reason for panic. More than half of the world’s population have such a “pathological” design of VC vessels, however, they live a long life without feeling negative manifestations at the physiological level.

Such a verdict should be a certain incentive for a person to change his life activity in the right and correct direction of attentive attitude to his health, regularly undergo preventive visits to doctors and fulfill their recommendations.

Diagnosis of anomalies

As a rule, abnormalities of the arterial circle are detected unexpectedly. This usually occurs with a detailed examination for the presence of concomitant symptoms (constantly spinning or headache).

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An accurate diagnosis of developmental disorders of the Willis circle is established exclusively by instrumental research methods:

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MRI and CT

MRI (magnetic resonance imaging) is one of the most accurate diagnostic methods. This is the safest way to obtain a detailed image, on which the structure of the vascular system of the brain is fixed.

The essence of the method is the use of a magnetic field and radio waves to fix the response of GM cells to their effects.

CT (computed tomography) – a method using x-ray irradiation. This study allows you to get more voluminous images that are captured at different angles. This method has contraindications.

Angiography

This is the most common method used to assess circulatory disorders in the brain.

Cerebral angiography allows you to study any vessels in as much detail as possible, which makes it an indispensable procedure in the diagnosis of cardiovascular diseases.

The principle of its operation is similar to a conventional x-ray, with the only difference that the vessels in the x-ray image are not visible, so they need to be contrasted. For this, during angiography, a puncture of the vessel is performed, then a catheter is inserted into it, through which an X-ray contrast drug is injected, which will reflect the radiation.

Thanks to this, it is possible not only to obtain a snapshot of the test vessel, but even to reproduce its three-dimensional image.

Dopplerography

Ultrasound dopplerography of cerebral vessels (USDG) is also one of the main diagnostic methods.

The principle of its work is the action of ultrasonic waves on the blood cells, reflected from them, the waves allow you to get a complete picture of the vessels and blood flow inside them.

With the help of ultrasound scan it is possible to get a comprehensive picture of the structure of blood vessels and arteries, the presence of pathologies and the speed of blood flow in them.

Treatment of anomalies in the developmental options of the Willis circle is not required. The vast majority of people do not even have an idea about their presence.

You need to treat diseases to which they can lead. Pathologies of the arterial circle belong to the field of neurology. Therefore, a neurologist appoints a course of therapy with drugs to normalize blood circulation.

The therapeutic course for pathologies of the Willis circle includes:

  • Ingestion or as an intravenous injection of drugs to improve blood circulation (Cavinton, Pentoxifylline).
  • The appointment of nootropics to improve brain metabolism (Fezam, Vinpotropil, Nootropil).
  • The course of antioxidants (Mexidol, Cytoflavin).
  • The course of metabolic drugs (Actovegin).
  • Vitamin therapy, B vitamins are especially useful.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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