BACKGROUND: Various cerebral pathological changes have been reported to cause leukoaraiosis (LA). We hypothesized that circle of Willis (CoW) anomalies may contribute to LA in severe carotid artery stenosis victims through impaired cerebral autoregulation. We conducted a retrospective review on cerebral magnetic resonance (MR) patterns in patients with severe symptomatic carotid artery stenosis and compared white matter lesion (WML) load between subjects with and without complete CoW. METHODS: LA on fluid attenuation inversion recovery (FLAIR) MR images at the levels of the centrum semiovale and frontal horns in both cerebral hemispheres were scored in 106 patients with unilateral carotid artery stenosis (64 men and 42 women; mean age 68.7 ± 9.2 years, range 44-82). Subjects were divided into groups of complete and incomplete CoW according to cerebral MR angiography. Differences in the LA scores between the groups of complete and incomplete CoW were further analyzed. RESULTS: Compared with those with incomplete configuration of the CoW, subjects with a complete CoW demonstrated a decreased WML load at the level of the centrum semiovale (2.78 ± 1.17 vs. 5.62 ± 2.12, p = 0.02) and frontal horns (2.21 ± 0.79 vs. 4.22 ± 1.83, p = 0.01). CONCLUSION: Our results support the importance of a complete CoW since it may protect from WML in case of carotid stenosis.
BACKGROUND: Various cerebral pathological changes have been reported to cause leukoaraiosis (LA). We hypothesized that circle of Willis (CoW) anomalies may contribute to LA in severe carotid artery stenosis victims through impaired cerebral autoregulation. We conducted a retrospective review on cerebral magnetic resonance (MR) patterns in patients with severe symptomatic carotid artery stenosis and compared white matter lesion (WML) load between subjects with and without complete CoW. METHODS: LA on fluid attenuation inversion recovery (FLAIR) MR images at the levels of the centrum semiovale and frontal horns in both cerebral hemispheres were scored in 106 patients with unilateral carotid artery stenosis (64 men and 42 women; mean age 68.7 ± 9.2 years, range 44-82). Subjects were divided into groups of complete and incomplete CoW according to cerebral MR angiography. Differences in the LA scores between the groups of complete and incomplete CoW were further analyzed. RESULTS: Compared with those with incomplete configuration of the CoW, subjects with a complete CoW demonstrated a decreased WML load at the level of the centrum semiovale (2.78 ± 1.17 vs. 5.62 ± 2.12, p = 0.02) and frontal horns (2.21 ± 0.79 vs. 4.22 ± 1.83, p = 0.01). CONCLUSION: Our results support the importance of a complete CoW since it may protect from WML in case of carotid stenosis.
Authors: Lars B Hindenes; Asta K Håberg; Liv Hege Johnsen; Ellisiv B Mathiesen; David Robben; Torgil R Vangberg Journal: PLoS One Date: 2020-11-03 Impact factor: 3.240