Circle of willis
The circle of Willis (circulus arteriosus cerebri) is an anastomotic system of arteries that sits at the base of the brain. The "circle" was named after Thomas Willis by his student Richard Lower. The circle of Willis encircles the stalk of the pituitary gland and provides important communications between the blood supply of the forebrain and hindbrain (ie, between the internal carotid and vertebrobasilar systems following obliteration of primitive embryonic connections). A complete circle of Willis is present in most individuals, although a well-developed communication between each of its parts is identified in less than half of the population. The circle of Willis is formed when the internal carotid artery (ICA) enters the cranial cavity bilaterally and divides into the anterior cerebral artery (ACA) and middle cerebral artery (MCA). The anterior cerebral arteries are then united by an anterior communicating (ACOM) artery. These connections form the anterior half (anterior circulation) of the circle of Willis. Posteriorly, the basilar artery, formed by the left and right vertebral arteries, branches into a left and right posterior cerebral artery (PCA), forming the posterior circulation. The PCAs complete the circle of Willis by joining the internal carotid system anteriorly via the posterior communicating (PCOM) arteries.
20 years ago this October I survived a complete rupture (blow out) of the right posterior communicating artery in the Circle of Willis. Twelve hours in the OR with a craniotomy and clip with my own colleagues working feverishly to replace the 2 units of O negative I blew through all 4 of my ventricles and down my cord, I survived with only minor sequelae (after a bout of E coli meningitis from a lumbar drain). It pays to be a trauma nurse at a University Trauma Center!
Neurofibromatosis
