Relationship Between The Integrity Of The Willis Ring And The Prognosis Of Patients With Acute Middle Cerebral Artery Stenosis

Aim:To investigate the relationship between the prognosis of patients with acute middle cerebral artery(MCA)stenosis and Willis ring integrity in Yanbian area and provide reference for the evaluation of prognosis of patients with acute ischemic stroke(AIS).Methods:The clinical data of 245 patients with acute MCA stenosis who were hospitalized in our department's Department of Neurology between January 2017 and December 2017 were collected and divided into 2 groups:1 group:118 patients in the complete group of Willis ring(44 cases in Korean and 74 cases in Han);Group 2:127 cases in the incomplete circle of Willis(49 cases in Korean and 78 cases in Han);The clinical data,the risk factors of cerebrovascular disease,the degree of MCA stenosis,the extent of cerebral infarction and the degree of neurological deficits were all related to the integrity of the Willis ring.All patients were followed up for 3 months to assess the relationship between short-term prognosis and the integrity of the Willis ring.Results:1.Comparison of clinical data and risk factors for cerebrovascular disease in group 1 and group 2,nationality,gender,age,and risk factors for cerebrovascular disease(hypertension,hyperlipidemia,diabetes,hyperhomocysteinemia,smoking)were not significantly associated with Willis ring integrity.2.The degree of stenosis of MCA in group 1 and group 2 was compared.There were 99 cases(84%)of mild-moderate vascular stenosis and 19 cases(16%)of severe stenosis or occlusion.There were 72 cases(57%)of mild-moderate vascular stenosis in 2 groups,and 55 cases(43%)of severe stenosis or occlusion.There was a statistically significant difference between the two groups(p<0.01).3.Compared with the area of cerebral infarction in group ? and group ?,the mean diameter of cerebral infarction in group I was 1.30(0.90-2.13)cm;in group ?,2.50(2.10-4.10)cm,there was statistical difference between the two groups(P<0.001).4.The degree of neurological deficit in group 1 and group 2 was compared.In group 1,107 cases(91%)had mild neurological deficits,10 cases(8%)were moderate,1 case(1%)was severe;Two groups of mild neurological deficits were 8 cases(6%),moderate 51 cases(40%),and severe 68 cases(54%).The completeness of Willis ring in severe neurological deficits was statistically different from mild to moderate(P<0.001).Spearman correlation analysis showed that the degree of neurological deficit was positively correlated with the integrity of the circle of Willis(p<0.01).5.The prognosis of group 1 was compared with that of group 2.One group had 111 cases(94%)with good prognosis,and 7 cases had poor prognosis(6%).The two groups had good prognosis in 23 cases(18%)and poor prognosis in 104 cases(82%).The statistical difference between the two groups was statistically significant(p<0.001),Spearman correlation analysis showed that the prognosis of cerebral infarction was positively correlated with the integrity of the circle of Willis(p<0.01).Conclusion:1.This study shows a positive correlation between the prognosis of cerebral infarction and the integrity of the Willis ring structure.The more complete Willis ring structure,the better the prognosis of cerebral infarction.2.This study shows that in patients with MCA stenosis,nationality,gender,age,and risk factors for cerebrovascular disease(hypertension,hyperlipidemia,diabetes,hyperhomocysteinemia,smoking)were not significantly related to the integrity of the Willis ring structure.