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Gross Anatomy of Circle of Willis and clinical Significance

Circle of Willis

Definition: a vascular circuit formed by the anastomoses between branches of the internal carotid arteries (anterior circulation) and vertebral arteries (posterior circulation) around the optic chiasm and pituitary stalk

Consists of paired:

Internal carotid arteries (proximal to the origin of the middle cerebral arteries)
Anterior cerebral arteries (terminal branches of the internal carotids)
Posterior cerebral arteries (terminal branches of the vertebral arteries)

Two anastomoses

Anterior communicating artery: connects the two anterior cerebral arteries
Posterior communicating artery (branch of internal carotid artery): connects the ICA to the posterior cerebral artery

Functional significance

The circuit provides alternative channels to bypass a potential site of vascular occlusion.
Equalizes arterial flow to both cerebral hemispheres

Clinical significance

Most saccular cerebral aneurysms, also known as berry aneurysms, occur in the anterior circulation of the brain, usually at the junction of the anterior cerebral artery and the anterior communicating artery in the circle of Willis. They are the most common cause of nontraumatic subarachnoid hemorrhage.

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