The implications of risk factors in the development of cerebrovascular disease in patients with anatomical variants in the Circle of Willis

Introduction: Risk factors for cerebrovascular disease (CVD) are nonmodifiable and modifiable. Non-modifiable factors are represented by: age, family history of CVD, race, sex, history of stroke or transient ischemic attack, and the following are considered modifiable factors: diet rich in fat and salt, sedentary lifestyle, obesity, smoking, hypertension, diabetes mellitus, hypercholesterolemia, arterial disease, peripheral artery disease, atrial fibrillation and sickle cell disease. It appears that modifiable factors are most involved in the occurrence of cerebrovascular disease, with some authors reporting a percentage of up to 90%. Material and method: We present a brief background of the literature on the interrelation between risk factors and the development of cerebrovascular disease in patients with anatomical variants in the Circle of Willis. There were performed a Google Scholar and also a MEDLINE search on PubMed using the following terms: “risk factors, stroke, anatomical variants, Circle of Willis” and “stroke, aneurysm, variants, Circle of Willis”. Results and Discussion: Non-modifiabible risk factors for stroke development are related to age, sex, ethnicity/race, genetical characteristics. Genetical characteristics have been associated with an increase of stroke development: parental or familial stroke history and the presence of a certain genetical mutation that can lead to stroke development. There are mentioned in literature as modifiable risk factors involved in the rupture of intracranial aneurysm: obesity, atherosclerosis, metabolic diseases, high blood pressure, in patients with anatomical variants in the circle of Willis. Anatomical variations in the circle of Willis are associated with increased odds of intracranial aneurysms. Conclusion: Understanding the anatomy of the most common variations and their prevalence in the general population would be indicated for the anticipation of cerebral stroke, either ischemic or hemorrhagic and of the affected regions.