Occupational Rehabilitation of Patients with Posterior Cerebral Artery Stroke and Anatomical Variations of the Circle of Willis

 I do wonder how you tell the variation in the Circle of Willis and with that  you should be able to tell if it is complete which would tell you if you should just close up blocked carotid arteries rather than stent them or do an endarterectomy with their attendant risks.

Occupational Rehabilitation of Patients with Posterior Cerebral Artery Stroke and Anatomical Variations of the Circle of Willis

Ana-Maria Dumitrescu1, Carmen Valerica Ripa2, Ioan Gotcă3, Irina-Luciana Gurzu4, Gica Avram Lehaci5, Roxana Gabriela Cobzaru6*, Ana-Maria Slanina7 and Anca Sava81 Occupational Health, Rehabilitation Clinical Hospital of Iasi, Romania, PhD student in Anatomy, “GrigoreT.Popa” University of Medicine and Pharmacy, Iasi, Romania2 Department of Microbiology, “GrigoreT.Popa” University of Medicine and Pharmacy, Iasi, Romania3 Clinical Psychologist ,"Dr. Ghelerter" Centre for Mental Health, Iasi, Romania4 Department of Preventive Medicine, “GrigoreT.Popa” University of Medicine and Pharmacy, Iasi, Romania5 "Grigore T.Popa” University of Medicine and Pharmacy, Iasi, Romania6 Department of Microbiology, “GrigoreT.Popa” University of Medicine and Pharmacy, Iasi, Romania7 Department of Family Medicine, “Grigore.T.Popa” University of Medicine and Pharmacy, Iasi, Romania8 Department of Morpho-functional Sciences I, “GrigoreT.Popa” University of Medicine and Pharmacy, Iasi, Romania*Corresponding author: Roxana-Gabriela Cobzaru

Abstract 

Aim and background: 

Considering its great importance in connecting the internal carotid with the vertebrobasilar system, the circle of Willis, a major anastomotic arterial system located at the base of the brain, may present various anatomical configurations that become possible triggers for certain cerebrovascular diseases such as strokes or aneurysms. The present study wants to highlight the importance of clinical findings related to anatomical variations in the circle of Willis that could lay at the basis of the development of posterior cerebral artery stroke (PCA stroke), interconnecting them with occupational rehabilitation of such patients. 

Material and methods: 

We did a research of data published over the last 1 years, from several international medical libraries and databases such as Pubmed, Google Scholar, Cambridge Core, using the following specific keywords combination: “circle of Willis, anatomical variants, posterior cerebral artery stroke, cognitive and language disorder”, and “posterior cerebral artery stroke, occupational therapy, occupational rehabilitation”. A descriptive review was realized describing several types of occupational rehabilitation techniques involved in the case of patients with PCA stroke, considered as a consequence of variations of the circle of Willis. 

Results: 

There are taken into consideration the connections between PCA stroke and specific clinical pathologies represented mainly by cognitive, behavioral, visual and language disorders and the rehabilitation in these cases, which has been little investigated in the specialty literature, with a focus on occupational therapy procedures. 

Conclusion: 

A correct knowledge upon the clinical consequences of anatomical variants of the circle of Willis, in this case, related to PCA stroke would be very useful not only to surgeons, pathologists and anatomists, but also to bedside clinicians.