ArticleBMC neurology2025
Superior circle of Willis configuration in oldest-old patients with first-ever ischemic stroke: a retrospective clinical-radiological study on its association with delayed onset and enhanced female prominence.
Article in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- An unusual variant of the anterior cerebral and anterior communicating arterial system: anatomical description with clinical and radiological implications.Surgical and radiologic anatomy : SRA · 2026Article
- Lipid feature and late onset ≥80 years of ischemic stroke: a retrospective study in lipid-lowering therapy-naive adults.Frontiers in neurologyArticle
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Abstract
backgroundThis study characterized the Circle of Willis (CoW) configuration in oldest-old (≥ 80 years) patients with first-ever acute ischemic stroke (AIS) and investigated its association with the age of AIS onset in the elderly.
methodsIn this retrospective, single-center clinical-radiological study, consecutive patients presenting with first-ever AIS at Bethune International Peace Hospital (Shijiazhuang, Hebei, China) between March 2022 and June 2024 were retrospectively enrolled and stratified into oldest-old (≥ 80) and elderly (60-79) groups. CoW morphology was assessed via brain magnetic resonance angiography (MRA) or computed tomography angiography (CTA) using CoW scores and types.
resultsA total of 276 patients were included in the final analysis based on our inclusion and exclusion criteria (188 aged 60-79; 88 aged ≥ 80). The oldest-old group (≥ 80 years) comprised a higher proportion of females (47.1% vs. 31.4%) and showed a greater prevalence of atrial fibrillation (17.1% vs. 5.3%) and coronary heart disease (26.1% vs. 10.6%) compared to the younger elderly group. The oldest-old group exhibited significantly higher anterior communicating artery (AcoA) scores, total CoW scores, and a greater prevalence of a complete CoW than the younger elderly group. A poorer CoW configuration was associated with an earlier age of AIS onset, while a higher AcoA score predicted a later onset, even after adjusting for risk factors. These associations were significantly more pronounced in females. Among females, the oldest-old had higher AcoA, posterior communicating artery (PcoA), and total CoW scores. The age of onset in females was significantly associated with AcoA score, total CoW score, and poorer configuration.
conclusionsOldest-old patients with first-ever AIS possess a more favorable CoW configuration than younger elderly patients, an association markedly enhanced in females.
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