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Anatomy of Neck and Blood Supply of Brain
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
Circle of Willis (Figure. 2.37) is an important communicating arterial system which inter-communicates with the carotid and the vertebral system of arteries supplying the brain. It is formed by:Bilateral posterior cerebral arteriesBilateral posterior communicating arteriesBilateral internal carotid arteriesBilateral anterior cerebral arteriesAnterior communicating arteries
Neuroanatomy
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
Which of the following statements concerning the vascular anatomy of the head and neck are true and which are false? The innominate artery gives rise to the right subclavian and right common carotid arteries.The external carotid initially courses antero-laterally before curving posteriorly behind the mandible.Amaurosis fugax is caused by the occlusion of the occipital artery, a branch of the external carotid artery.Lacunar infarcts account for more than 20% of all strokes.A complete circle of Willis is present in more than 50% of patients.
Adult Autopsy
Published in Cristoforo Pomara, Vittorio Fineschi, Forensic and Clinical Forensic Autopsy, 2020
Cristoforo Pomara, Monica Salerno, Vittorio Fineschi
Prior to brain dissection, photographs and measurements should be taken. If there are any concerns about vascular integrity, photographs of the circle of Willis (also called the Willis polygon) should be taken before it is incised and removed as one block (Figures 2.158–2.161).
Delineation atlas of the Circle of Willis and the large intracranial arteries for evaluation of doses to neurovascular structures in pediatric brain tumor patients treated with radiation therapy
Published in Acta Oncologica, 2021
L. Toussaint, S. Peters, R. Mikkelsen, S. Karabegovic, C. Bäumer, L. P. Muren, L. Tram-Henriksen, M. Høyer, Y. Lassen-Ramshad, B. Timmermann
Long-term survivors of pediatric brain tumors treated with radiation therapy are at an increased risk of developing cerebrovascular disease compared to the general population [1–4]. Damage to the major cerebral arteries of the brain, in part forming the Circle of Willis (CW), may lead to stenosis or occlusion of these large vessels. In the literature, stenosis and occlusive changes in patients treated with radiotherapy during childhood have been reported mostly in the proximal segment of the middle cerebral artery, the terminal part of the internal carotid artery as well as the anterior circulation of the CW [5–7]. Clinically, the patients may present with potentially life-threatening transient ischemic attacks, intracranial hemorrhages or ischemic strokes for which they remain at increased risk throughout their lifespan compared to their peers [1–4], affecting their quality of life.
MRI detection of brain abnormality in sickle cell disease
Published in Expert Review of Hematology, 2021
Hanne Stotesbury, Jamie Michelle Kawadler, Dawn Elizabeth Saunders, Fenella Jane Kirkham
The majority of SCD patients with stroke have a narrowing of the arteries of the Circle of Willis at the base of the brain [11,45], associated with cerebral infarction either in the middle cerebral artery territory or more characteristically in the superficial and deep borderzones between the anterior and middle cerebral artery territories. In the SWiTCH trial which randomized 161 children with SCD who had previously had a stroke to continue regular transfusion or to start hydroxyurea and phlebotomy, around a third had no stenosis on either side despite having previously had a stroke [10]. Children with low or uninterpretable TCD velocities had the worst stenosis and children who had stroke or transient ischemic attacks during the trial had substantial vessel stenosis and parenchymal injury; in one the vasculopathy had evolved from grade 0 to grade 5 in association with a stroke [10]. At exit, of 112 children, one had worse stenosis and one had a new SCI, both in the hydroxyurea and phlebotomy arm. Others have also found that in patients with SCD and stroke, MRA abnormalities progress even with chronic blood transfusion [23], particularly if there was more severe abnormality at baseline [54].
Surgical treatment of foreign body embolus in the Middle cerebral artery secondary to neck injury
Published in British Journal of Neurosurgery, 2020
Hui Wang, Xin-Jie Ning, Chuan Chen, Cong Lin, Jia-Ji Liang, Yu-Zhang Li
Currently, there are three surgical methods for the management of foreign body embolus in intracranial arteries. The first method is retrograde displacement combined with artery occlusion. Craniotomy is performed to locate the foreign body, which is retrogradely removed from the MCA to the internal carotid artery without surgical incision of the arteries. Then, the foreign body is isolated after temporal occlusion of the internal carotid artery. This surgical procedure is only applied in cases in which the foreign body is not closely adhered to the arterial wall and the circle of Willis is normal. The second method is arteriotomy and suturing for removal of foreign body, which is a simple and optimal method to restore the blood flow to normal levels. During this surgical intervention, the foreign body–induced granulation tissue should be removed along with the foreign body. Finally, the third method is extracranial-intracranial (EC-IC) vascular bypass.24 If the arterial injuries induced by the foreign body cannot be repaired, EC-IC vascular bypass is an option. In our case, the superficial temporal artery was retained with this in mind.