Assessment of Collateral Circulation Effect on the Cerebral Perfusion Changes in Group of Patients with Aterosclerotic Occlusion of the Main Brachiocephalic Arteries

Aim. Comparative evaluation between segmental anatomy of the circle of Willis and brain CT-perfusion parameters, in group of patient with widespread atherosclerosis and unilateral brachiocephalic artery occlusion. Materials and methods. 24 patient, who underwent native brain CT, brain CT-perfusion and CT-angiography were included in our study. All patients had unilateral atherosclerotic occlusion one of the main brachiocephalic artery. Basic group of patients was carried out by subgroups, depending on the anatomical structure of the circle of Willis. CT-perfusion changes were compared between subgroups. Presence of post-ischemic changes and severity of atherosclerotic lesions on the contrary side were described. Results. More than half of patients (66.7%) had unilateral carotid artery occlusion, combined with contralateral carotid stenosis, which includes 6 cases of critical stenosis. In 59% of cases different steno-occlusive lesions of vertebrobasilar arteries was found. Inter-emispheric cerebral perfusion differences were significant between the ipsilateral and contrary side in a ROI of arteria cerebri media (ACM). Also, significant ratio between the value of inter-hemispheric difference and anatomic variations of the circle of Willis were found. No relation was found between inter-hemispheric perfusion difference and presence of post-ischemic changes or severity of the contralateral stenosis. Conclusion. Between different, heterogeneous subgroups with different variations of the circle of Willis, significant difference in inter-hemispheric cerebral perfusion was present.

КТ-перфузия, головной мозг, атеросклероз, окклюзия, брахиоцефальные артерии, CT-perfusion, brain, atherosclerosis, occlusion, brachiocephalic arteries

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