| A1 Segment Hypoplasia/aplasia Detected by Magnetic Resonance Angiography in Neuropediatric Patients. |
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Yoon Ki Han, Seung Kim, Choon Sik Yoon, Young Mock Lee, Hoon Chul Kang, Joon Soo Lee, Heung Dong Kim |
1Department of Pediatrics, Gangnam Severance Hospital, Severance Children's Hospital Yonsei University College of Medicine, Seoul, Korea. ymleemd@yuhs.ac
2Department of Radiology, Gangnam Severance Hospital Yonsei University College of Medicine, Seoul, Korea. |
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| Abstract |
PURPOSE
A variation in the circle of Willis is not so common, but the most frequent type is hypoplasia/aplasia of the precommunicating anterior cerebral arteries (A1 segment). We aimed to examine the incidence and the clinical significance of A1 segment hypoplasia/aplasia in neuropediatric patients. METHODS: We retrospectively studied children with A1 segment hypoplasia/aplasia in brain magnetic resonance angiography (MRA) and compared the clinical and radiological aspects between children with A1 segment hypoplasia/aplasia alone and with other variations in the circle of Willis. RESULTS: Among 301 patients, 34 patients (11.3%) had A1 segment hypoplasia/aplasia. They presented neurological symptoms such as chronic headache, dizziness and visual disturbance. Seven (20.6%) had family history of neurological illness. Twenty seven (79.4%) had A1 segment hypoplasia/aplasia only, and seven (20.6%) had another vascular abnormality. Seven (20.6%) showed abnormal brain magnetic resonance angiography (MRI) results, cerebral atrophy being the most frequent (n=5, 14.7%). The incidence of abnormal brain MRI was 11.1% (n=3) in single vascular abnormality and 57.1% (n=4), significantly higher (p-value 0.02) in combined abnormality group. CONCLUSION: Structural alterations in the cerebral vasculature in children have important pathophysiological and clinical implications. Evaluation of variations in the circle of Willis, especially of A1 segment hypoplasia/aplasia using MRA is recommended. |
| Key Words:
Circle of Willis, A1 segment, Hypoplasia, Aplasia, Magnetic resonance angiography |
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