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Circle of Willis

From Wikipedia, the free encyclopedia

Artery: Circle of Willis
Schematic representation of the circle of Willis, arteries of the brain and brain stem.
The brain and the arteries of the base of the brain. The temporal pole of the cerebrum and a portion of the cerebellar hemisphere have been removed on the right side. Inferior aspect (viewed from below).
Latin circulus arteriosus cerebri
Gray's subject #147 574
MeSH A07.231.114.228.351

The circle of Willis (also called the cerebral arterial circle or arterial circle of Willis) is a circle of arteries that supply the brain. It is named after Thomas Willis (1621-1673), an English physician.[1]

Contents

[edit] Components

The basilar artery and middle cerebral arteries, though they supply the brain, are not considered part of the circle.[2]

[edit] Physiologic significance

The arrangement of the brain's arteries into the Circle of Willis creates redundancies in the cerebral circulation. If one part of the circle becomes blocked or narrowed (stenosed) or one of the arteries supplying the circle is blocked or narrowed, blood flow from the other blood vessels can often preserve the cerebral perfusion well enough to avoid the symptoms of ischemia.[3]

[edit] Anatomic variation

Considerable anatomic variation exists in the circle of Willis. The "textbook version" of the circle, based on a series of 1413 brains, is only seen in 34.5% of cases.[4]

[edit] Subclavian steal and the circle of Willis

The redundancies that the circle of Willis introduce can also lead to reduced cerebral perfusion.[5][6] In subclavian steal syndrome, which results from a proximal stenosis (narrowing) of the subclavian artery (a vessel that supplies a vessel that feeds the circle of Willis), blood is "stolen" from the circle of Willis to preserve blood flow to the upper limb.

[edit] Origin of arteries

The left and right internal carotid arteries arise from the right and left common carotid arteries.

The anterior cerebral arteries and posterior communicating arteries arise from the internal carotid arteries' trifurcations.

The right and left posterior cerebral arteries arise from the basilar artery, which is formed by the left and right vertebral arteries. The vertebral arteries arise from the subclavian arteries.

The anterior communicating artery connects the two anterior cerebral arteries and could be said to arise from either the left or right side.

[edit] References

  1. ^ Uston C. Dr. Thomas Willis' famous eponym: the circle of Willis. J Hist Neurosci. 2005 Mar;14(1):16-21. PMID 15804755. Free Full Text.
  2. ^ Moore KL, Dalley AR. Clinically Oriented Anatomy, 4th Ed., Lippincott Williams & Wilkins, Toronto. Copyright 1999. ISBN 0-683-06141-0.
  3. ^ "Spect measurements of regional cerebral perfusion and carbondioxide reactivity: Correlation with cerebral collaterals in internal carotid artery occlusive disease.". J Neurol. PMID 17063318.
  4. ^ Bergman RA, Afifi AK, Miyauchi R, Circle of Willis. Illustrated Encyclopedia of Human Anatomic Variation, URL: http://www.anatomyatlases.org/AnatomicVariants/Cardiovascular/Text/Arteries/CircleofWillis.shtml. Accessed on November 6, 2005.
  5. ^ Klingelhofer J, Conrad B, Benecke R, Frank B. Transcranial Doppler ultrasonography of carotid-basilar collateral circulation in subclavian steal. Stroke. 1988 Aug;19(8):1036-42. PMID 3041649.
  6. ^ Lord RS, Adar R, Stein RL. Contribution of the circle of Willis to the subclavian steal syndrome. Circulation. 1969 Dec;40(6):871-8. PMID 5377222.

[edit] External links

Arteries of head and neckedit

EXTERNAL CAROTID: Anterior: superior thyroid - superior laryngeal - lingual (sublingual)

facial: cervical branches (ascending palatine - tonsillar - submental) - facial branches (inferior labial - superior labial - lateral nasal - angular)

Posterior and ascending: occipital - posterior auricular - stylomastoid - ascending pharyngeal (meningeal branches)
Terminal: superficial temporal - transverse facial - middle temporal (zygomaticoörbital) - parietal branch
internal maxillary - 1st part: anterior tympanic - deep auricular - middle meningeal - superior tympanic - accessory meningeal - inferior alveolar - lingual
2nd part: deep temporal - masseteric - buccinator - posterior superior alveolar
3rd part: infraorbital - descending palatine - artery of the pterygoid canal - sphenopalatine | (Gray's s144)

INTERNAL CAROTID: cervical portion - petrous portion - cavernous portion
ophthalmic - orbital group: lacrimal - supra-orbital - posterior ethmoidal - anterior ethmoidal - medial palpebral - supratrochlear - dorsal nasal
ocular group: central retinal - ciliary
cerebral portion: anterior cerebral - anterior communicating - middle cerebral - posterior communicating - anterior choroidal - circle of Willis | (Gray's s146 - Gray's s147)

SUBCLAVIAN: vertebral: meningeal branches - posterior spinal - anterior spinal - posterior inferior cerebellar - basilar (internal auditory - anterior inferior cerebellar - superior cerebellar - posterior cerebral)
thyrocervical trunk: inferior thyroid - inferior laryngeal - ascending cervical - suprascapular - transverse cervical - dorsal scapular
internal thoracic: musculophrenic - anterior intercostal - pericardiacophrenic - superior epigastric
costocervical trunk: highest intercostal, deep cervical | (Gray's s148)

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