title: The Circle of Willis and White Matter Lesions in Patients with Carotid Atherosclerosis.
abstract: BACKGROUND
  The correlation between cerebral atherosclerosis and white matter lesions (WMLs) in the elderly was controversial in the published articles, where the stenosis was often evaluated by ultrasonography, computed tomography angiography, or magnetic resonance angiography and collaterals were seldom considered. We hypothesized that collaterals influence WMLs. Our study was to explore the relationship between the circle of Willis and WMLs in a retrospective, hospital-based cohort of patients with carotid atherosclerosis.
  
  
  METHODS
  Two hundred eighty-six patients with carotid atherosclerosis were enrolled from the Nanjing Stroke Registry. They underwent magnetic resonance imaging evaluating WMLs and digital subtraction angiography evaluating both carotid atherosclerosis and collateral capacity of the circle of Willis. We tested the association between severe carotid atherosclerosis, the circle of Willis, and WMLs by logistic regression analysis.
  
  
  RESULTS
  Severity of carotid atherosclerosis was not significantly associated with either periventricular or deep WMLs (P = .656 and .566, respectively). Number of carotid arteries with severe stenosis was not associated with the severity of either periventricular or deep WMLs (P = .721 and .263, respectively). Patency of the communicating arteries (CoA) was not associated with periventricular or deep WMLs (P = .561 and .703, respectively). Advanced age and hypertension were associated with periventricular WMLs (P = .001 and .008, respectively). Advanced age, hypertension, and prior stroke were associated with deep WMLs (P = .049, .048, and .001, respectively).
  
  
  CONCLUSIONS
  The circle of Willis and severe carotid atherosclerosis may not be related to WMLs. Further larger studies are warranted to confirm or refute our findings.
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. Electronic address: lihualtl@sina.cn.
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Renliang
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Wusheng
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Yin
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Minmin
authors.initials: M
authors.lastname: Ma
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Zuowei
authors.initials: Z
authors.lastname: Duan
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000473:pathology*; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D015898:Tomography Scanners, X-Ray Computed; D014463:Ultrasonography; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: White matter lesions; atherosclerosis; collateral; ischemic stroke