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Co-existing neuropathological comorbidities have been repeatedly reported to be extremely common in subjects dying with dementia due to Alzheimer disease. As these are likely to be additive to cognitive impairment, and may not be affected by molecularly-specific AD therapeutics, they may cause significant inter-individual response heterogeneity amongst subjects in AD clinical trials. Furthermore, while originally noted for the oldest old, recent reports have now documented high neuropathological comorbidity prevalences in younger old AD subjects, who are more likely to be included in clinical trials.
View Article and Find Full Text PDFPrognostic analysis of endovascular mechanical thrombectomy in stroke patients with acute internal carotid artery obstruction based on circle of Willis variation.
Front Neurol
January 2025
Department of Neurosurgery, Shaoxing People's Hospital, Shaoxing, China.
Objective: Endovascular mechanical thrombectomy (EVMT) is widely employed in patients with acute intracranial carotid artery occlusion (AIICAO). This study aimed to predict the outcomes of EVMT following AIICAO by utilizing anatomic classification of the circle of Willis and its relative position to the thrombus.
Methods: In this study, we retrospectively analyzed a cohort of 108 patients with AIICAO who underwent endovascular mechanical thrombectomy (EVMT) at Shaoxing People's Hospital.
Impact of A1 segment asymmetry on hemodynamic conditions around the circle of Willis and anterior communicating artery aneurysm formation.
Front Neurol
January 2025
Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea.
Background: This study aims to investigate how A1 segment asymmetry-also known as A1 dominancy-influences the development of the anterior communicating artery aneurysm (AcomA) as it affects hemodynamic conditions within the circle of Willis (COW). Using time-of-flight magnetic resonance angiography (TOF-MRA), the research introduces a novel approach to assessing shear stress in A1 segments to uncover the hemodynamic factors contributing to AcomA formation.
Method: An observational study was conducted over 6 years at a tertiary university hospital's outpatient clinic.
Endovascular versus Best Medical Treatment for Acute Carotid Occlusion BelOw Circle of Willis (ACOBOW): The ACOBOW Study.
Radiology
January 2025
From the Dept of Diagnostic and Interventional Neuroradiology, Univ Medical Ctr Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (L.M., G.B., P.S., J.F., C.P.S.); Dept of Diagnostic and Interventional Neuroradiology, Hosp Bremen-Mitte, Bremen, Germany (M.A., P.P.); Interventional Neuroradiology Section, Dept of Radiology, Donostia Univ Hosp, Donostia-San Sebastián, Spain (Á.L., J.Á.L.); Clinic for Radiology, Section for Interventional Radiology, Univ of Münster and Univ Hosp Münster, Münster, Germany (W.S., H.K., C.P.S.); Dept of Neuroradiology, Westpfalz-Klinikum, Kaiserslautern, Germany (W.N.); Dept of Neuroradiology, Otto-von-Guericke-Universitätsklinikum Magdeburg, Magdeburg, Germany (D.B., M.T.); Inst for Diagnostic and Interventional Radiology and Neuroradiology, Univ Hosp Essen, Essen, Germany (H.S., C.D.); Dept of Neuroradiology, Univ of Cologne, Cologne, Germany (C.K., C.Z.); Dept of Neuroradiology, Univ Hosp Aachen, Aachen, Germany (C.W., M. Möhlenbruch); Dept of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical Univ Munich, Munich, Germany (M.R.H.P., C.M.); Inst of Neuroradiology, Univ Hosps, LMU Munich, Munich, Germany (H.Z.); Dept of Diagnostic and Interventional Neuroradiology, Univ Medical Ctr Goettingen, Goettingen, Germany (M. Ernst, A.J.); Interventional Neuroradiology, Dept of Radiology, Hosp Clínico San Carlos, Madrid, Spain (M.M.G., C.P.G.); Dept of Neuroradiology, Hosp Universitario La Paz, Madrid, Spain (P.N., A.F.P.); Div of Neurology, Dept of Medicine (L.Y., B.T.), and Div of Interventional Radiology, Dept of Diagnostic Imaging (A.G.), National Univ Health System, Singapore; Yong Loo Lin School of Medicine, National Univ of Singapore, Singapore (L.Y., B.T., A.G.); Inst of Neuroradiology, Charité Universitätsmedizin Berlin, Berlin, Germany (E.S., M. Miszczuk); Dept of Neuroradiology, Clinic and Policlinic of Radiology, Univ Hosp Halle/Saale, Halle, Germany (S.S.); Dept of Radiology and Neuroradiology, Stadtspital Zürich, Zürich, Switzerland (P.S.); Dept of Diagnostic and Interventional Neuroradiology, Univ Hosp Basel, Basel, Switzerland (P.S., M.P.); Depts of Interventional Neuroradiology (J.Z.P.) and Neurology (G.P.), Hosp Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Dept of Neuroradiology, Karolinska Univ Hosp and Dept of Clinical Neuroscience, Karolinska Inst, Stockholm, Sweden (F.A., T.A.); Dept of Medical Imaging, AZ Groeninge, Kortrijk, Belgium (T.A.); Dept of Radiology, Comenius Univ's Jessenius Faculty of Medicine and Univ Hosp, Martin, Slovakia (K.Z.); Dept of Radiology, Aretaieion Univ Hosp, National and Kapodistrian Univ of Athens, Athens, Greece (P.P.); Dept of Neuroradiology, Univ Hosp Marburg, Marburg, Germany (A.K.); Dept of Neuroradiology, Univ Hosp of Bonn, Bonn, Germany (F.D.); and Dept of Neuroradiology, Alfried Krupp Krankenhaus, Essen, Germany (M. Elsharkawy).
Background Symptomatic acute occlusions of the internal carotid artery (ICA) below the circle of Willis can cause a variety of stroke symptoms, even if the major intracranial cerebral arteries remain patent; however, outcome and safety data are limited. Purpose To compare treatment effects and procedural safety of endovascular treatment (EVT) and best medical treatment (BMT) in patients with symptomatic acute occlusions of the ICA below the circle of Willis. Materials and Methods This retrospective, multicenter cohort study from 22 comprehensive stroke centers in Europe and Asia includes patients treated between January 1, 2008, and December 31, 2022.
View Article and Find Full Text PDFSex-specific anatomical variation of circle of Willis arteries.
Neuroimage
January 2025
Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands. Electronic address:
Background: Anatomical variations in the circle of Willis (CoW) arteries are common and can affect hemodynamic stress, thereby influencing the risk of cerebrovascular pathology. Previous studies have suggested sex differences in CoW anatomy, but findings vary due to limited study population size and different measurement methods. This study aims to investigate sex differences in artery diameters, anatomical variants and bifurcation angles of the CoW using a large population cohort and semi-automatic measurements.
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