title: Associations between Circle of Willis morphology and white matter lesion load in subjects with carotid artery stenosis.
abstract: 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).
  
  
  CONCLUSIONS
  Our results support the importance of a complete CoW since it may protect from WML in case of carotid stenosis.
authors.affiliation: Department of Neurology, Far-Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Chuang
authors.forename: Kuo-Lun
authors.initials: KL
authors.lastname: Huang
authors.forename: Yeu-Jhy
authors.initials: YJ
authors.lastname: Chang
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chang
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Chang
authors.forename: Tai-Cheng
authors.initials: TC
authors.lastname: Wu
authors.forename: Ching-Po
authors.initials: CP
authors.lastname: Lin
authors.forename: Ho-Fai
authors.initials: HF
authors.lastname: Wong
authors.forename: Shan-Jin
authors.initials: SJ
authors.lastname: Liu
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000000981:diagnostic imaging / Q000209:etiology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors