3/7/2020 Circle of Willis - Wikipedia

Circle of Willis
The circle of Willis (also called Willis' circle, loop of
Circle of Willis
Willis, cerebral arterial circle, and Willis polygon) is a
circulatory anastomosis that supplies blood to the brain and
surrounding structures. It is named after Thomas Willis
(1621–1675), an English physician.[1]

Contents
Structure
Origin of arteries
Variation
Function
Clinical significance
Aneurysms
Subclavian steal syndrome
Additional images
See also
References
External links Schematic representation of the circle
of Willis, arteries of the brain and brain
stem. Blood flows up to the brain
Structure through the vertebral arteries and
through the internal carotid arteries.
The circle of Willis is a part of the cerebral circulation and is
composed of the following arteries:[2]

Anterior cerebral artery (left and right)

Anterior communicating artery
Internal carotid artery (left and right)
Posterior cerebral artery (left and right)
Posterior communicating artery (left and right)
The middle cerebral arteries, supplying the brain, are not
considered part of the circle.

Origin of arteries
The left and right internal carotid arteries arise from the left
and right common carotid arteries. The arteries of the base of the brain.
Basilar artery labeled below center. The

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The posterior communicating artery is given off as a branch of temporal pole of the cerebrum and the
the internal carotid artery just before it divides into its cerebellar hemisphere have been
terminal branches - the anterior and middle cerebral arteries. removed on the right side. Inferior
The anterior cerebral artery forms the anterolateral portion of aspect (viewed from below).
the circle of Willis, while the middle cerebral artery does not Details
contribute to the circle.
Identifiers
The right and left posterior cerebral arteries arise from the Latin Circulus arteriosus cerebri
basilar artery, which is formed by the left and right vertebral Circulus Willisi
arteries. The vertebral arteries arise from the subclavian MeSH D002941 (https://meshb.nlm.ni
arteries. h.gov/record/ui?ui=D002941)
TA A12.2.07.080 (http://www.unifr.c
The anterior communicating artery connects the two anterior
h/ifaa/Public/EntryPage/TA98%
cerebral arteries and could be said to arise from either the left
20Tree/Entity%20TA98%20EN/
or right side.
12.2.07.080%20Entity%20TA9
All arteries involved give off cortical and central branches. The 8%20EN.htm)
central branches supply the interior of the circle of Willis, FMA 50454 (https://bioportal.bioontol
more specifically, the Interpeduncular fossa. The cortical ogy.org/ontologies/FMA/?p=clas
branches are named for the area they supply. Since they do not ses&conceptid=http%3A%2F%
directly affect the circle of Willis, they are not dealt with here. 2Fpurl.org%2Fsig%2Font%2Ff
ma%2Ffma50454)

Variation Anatomical terminology

Considerable anatomic variation exists in the circle of Willis. Based on a study of 1413 brains, the
classic anatomy of the circle is only seen in 34.5% of cases.[3] In one common variation the proximal
part of the posterior cerebral artery is narrow and its ipsilateral posterior communicating artery is
large, so the internal carotid artery supplies the posterior cerebrum; this is known as a fetal posterior
communicating cerebral artery. In another variation the anterior communicating artery is a large
vessel, such that a single internal carotid supplies both anterior cerebral arteries; this is known as an
azygos anterior cerebral artery.

Function
The arrangement of the brain's arteries into the circle of Willis creates redundancy (analogous to
engineered redundancy) for collateral circulation in the cerebral circulation. If one part of the circle
becomes blocked or narrowed (stenosed) or one of the arteries supplying the circle is blocked or
narrowed, blood flow from the other blood vessels can often preserve the cerebral perfusion well
enough to avoid the symptoms of ischemia.[4]

Clinical significance

Aneurysms

Subclavian steal syndrome

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The redundancies that the circle of Willis introduce can also lead to
reduced cerebral perfusion.[5][6] In subclavian steal syndrome,
blood is "stolen" from the circle of Willis to preserve blood flow to
the upper limb. Subclavian steal syndrome results from a proximal
stenosis (narrowing) of the subclavian artery, an artery supplied by
the aorta, which is also the same blood vessel that eventually feeds
the circle of Willis via the vertebral and internal carotid arteries.

Additional images

Fetal ultrasound Cerebral angiogram

image at the level of showing an
circle of Willis, anterior/posterior
showing PCA, MCA projection of the
and ACA vertebrobasilar and
posterior cerebral
circulation, the
posterior aspect of
the circle of Willis,
and one of its Circle of Willis with the most
feeding vessels common locations of ruptured
aneurysms marked

An anterior view of
major cerebral and
cerebellar arteries.

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Circle of Willis Circle of Willis

See also
Cerebral circulation
Leptomeningeal collateral circulation

References
1. Uston, Cagatay (9 March 2005). "NEUROwords Dr. Thomas Willis' Famous Eponym: The Circle
of Willis". Journal of the History of the Neurosciences. 14 (1): 16–21.
doi:10.1080/096470490512553 (https://doi.org/10.1080%2F096470490512553). PMID 15804755
(https://pubmed.ncbi.nlm.nih.gov/15804755).
2. Purves, Dale; George J. Augustine; David Fitzpatrick; William C. Hall; Anthony-Samuel LaMantia;
James O. McNamara; Leonard E. White (2008). Neuroscience (https://web.archive.org/web/2007
1207215307/http://www.sinauer.com/neuroscience4e/) (4th ed.). Sinauer Associates. pp. 834–5.
ISBN 978-0-87893-697-7. Archived from the original (http://www.sinauer.com/neuroscience4e) on
2007-12-07.
3. Bergman, Ronald A.; Afifi, Adel K.; Miyauchi, Ryosuke (2005). "Circle of Willis" (https://www.anato
myatlases.org/AnatomicVariants/Cardiovascular/Text/Arteries/CircleofWillis.shtml). Illustrated
Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Head,
Neck, and Thorax.
4. Boorder, Michiel J.; Grond, Jeroen; Dongen, Alice J.; Klijn, Catharina J.M.; Jaap Kappelle, L.; Rijk,
Peter P.; Hendrikse, Jeroen (24 October 2006). "Spect measurements of regional cerebral
perfusion and carbondioxide reactivity: Correlation with cerebral collaterals in internal carotid
artery occlusive disease". Journal of Neurology. 253 (10): 1285–1291. doi:10.1007/s00415-006-
0192-1 (https://doi.org/10.1007%2Fs00415-006-0192-1). PMID 17063318 (https://pubmed.ncbi.nl
m.nih.gov/17063318).
5. Klingelhöfer, J; Conrad, B; Benecke, R; Frank, B (August 1988). "Transcranial Doppler
ultrasonography of carotid-basilar collateral circulation in subclavian steal". Stroke. 19 (8): 1036–
1042. doi:10.1161/01.str.19.8.1036 (https://doi.org/10.1161%2F01.str.19.8.1036). PMID 3041649
(https://pubmed.ncbi.nlm.nih.gov/3041649).
6. Lord, Reginald S. A.; Adar, Raphael; Stein, Robert L. (December 1969). "Contribution of the Circle
of Willis to the Subclavian Steal Syndrome". Circulation. 40 (6): 871–878.
doi:10.1161/01.cir.40.6.871 (https://doi.org/10.1161%2F01.cir.40.6.871). PMID 5377222 (https://pu
bmed.ncbi.nlm.nih.gov/5377222).

External links

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3/7/2020 Circle of Willis - Wikipedia

Bergman, Ronald A.; Afifi, Adel K.; Miyauchi, Ryosuke. "Fourteen Variations of Circle of Willis and
Related Vessels" (https://www.anatomyatlases.org/AnatomicVariants/Cardiovascular/Images0200/
0292.shtml). Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular
System.

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