Ingqungquthela ye-Willis kunye nokuhluka kohlobo lwayo

Ingqungquthela ye-Willis yinto yokwenza i-anatomiki yeempahla ezisekwe kwindawo esekelwe kwingqondo, eqinisekisa ukuphindaphinda kwegazi phakathi kwamachibi ahlukahlukeneyo asetsheni phambi kokungenayo okwenziwe ngegazi kwingqondo. Le ipoloni evaliweyo, eyi-anastomosis ye-vascular.

Ingqungquthela ye-Willis ibunjwa ukusuka kwimibhobho engxenyeni yangaphambili nangemva kwayo (PSA no-ЗСА), amacandelo okuqala emibhobho ye-cerebral yangaphambili nangemva kwayo (PAMА and ЗМА), icandelo le-supraglinic yombane we-carotid yangaphakathi (BCA) kunye nengxenye ye-distal ye-artery enkulu (OA).

Kwinqanaba layo langaphambili, kukho ukujikelezwa kwezinto ezinobuncwane phakathi kweenkqubo ze- carotid artery (umzekelo, i-ICA kunye ne-PMA kwicala lasekunene -PSA - BCA kunye ne-PMA kwicala lasekhohlo), kunye nakwindawo yokugcina yangaphakathi - phakathi kwenkqubo ye-carotid kunye ne-vertebrobasilar system (BCA - 3CA - ZMA - OA ).

Kubalulekile ukuba uqaphele ukuba isangqa esivame ukuphuhliswa kwaye sivalwe ngokupheleleyo i-Willis sitholakala kuphela kwisiqingatha selizwe labantu. Ixhaphake yi-hypoplasia okanye i-aplasia ye-ZMA kunye ne-PMA, kunye ne-hypoplasia ye-PSA kunye ne-PSA. Kwinqanaba langaphambili, ukungaqhelekanga kubonakala kungaphantsi kancinci kunezinye izinto ezingabonakaliyo kwisakhiwo sendawo engezantsi.

I-PSA iyatshintsha kakhulu kwisakhiwo sayo, ubungakanani kunye nendawo: okukhethwa kukho kunokwenzeka ekubeni kungabikho ngokupheleleyo kwi-fistula ebanzi kwindawo yokudibanisa ne-PMA, mhlawumbi iphindwe kabini okanye i-PSA ye-tripling. Kunqabile kakhulu ukuba kukho "ukuhlanjululwa komhlaba" kweyeriyeri yangaphambili: zombini ii-PMA ziqala kwi-ICA eyodwa. Kule meko, isangqa se-Willis siyavuleka kwicandelo langaphambili. Ngona i-anomaly engabonakaliyo kubakho kwe-PMA eyongezelelweyo, ebizwa ngokuba ngumthi weWilder.

Isebe elingasemva lifunyenwe kuphela kwisiqingatha selizwe labantu. Ama-anomali kwinqanaba elingasemva lingahluke kakhulu: ukuhlakazeka okukhulu kwemilinganiselo, ukuhlukana okukhulu kwamasebe emibhobho, ukungabikho kwamacandelo okanye nemibhobho. I-anomaly eqhelekileyo yohlukwano kwi diameter yemithambo ye-vertebral: i-hypoplasia enye kunye ne-hypertrophy enye enye. Kwinqanaba langoku, kukholelwa ukuba omnye umthambo we-vertebral ulawulwa, kwaye okwesibini ukugqithisa ngokwemali yegalelo labo elipheleleyo kwigazi le-vertebrobasilar basin. I-asymmetry evumelekileyo i-50%. I-DSA ngobubanzi ihlala iphantsi kwe-PSA. Kwakhona kuqhelekile iHSA hypoplasia.

Utshintsho lophuhliso lwangqangi lwe-Willis luyinto engabonakaliyo yesakhiwo se-vertebrobasilar system: akukho manyano opheleleyo weemitha zomzimba zombini kwi-artery ephezulu, i-anastomoses yesakhiwo esingalunganga okanye imirhoxo inokwenzeka ukuba yodwa. Kwimeko yokugqithisa umthambo ophezulu okanye i-ACA, kuvulwa ukuvula kwinqanaba eliphambili lomjikelezo wobomi wengqondo. Kuvela kwingxenyana yangemva apho kukho amasebe ajikelezayo eya kubomi obuphakathi kunye naphakathi. Kuvela ukuba isangqa evulekile sikaWillis sinokuba kwicandelo langaphambili, kwaye ngasemva. Ngaphezu koko, iyakwazi ukuvuleka ngokupheleleyo (iimbumba ezinobungozi ezingekho) kwaye zingenakwenzeka (kunye ne-hypoplasia okanye i-constriction).

Utshintsho kwisakhiwo esiqhelekileyo sesangqa sengqondo sinobubele kunye nesifumanekayo-isiphumo sokuguqulwa kwamalungu athile kwiimeko ezitshintshileyo ze-hemodynamics kunye neentlobo ezahlukeneyo zeenqanawa eziphambili zentloko, ezihlala zikhula kule meko. Ukuphononongwa kweempawu ezithile kwisakhiwo sebhedi ye-vascular kuncike kwi-angiography kwaye kubaluleke kakhulu ekusebenzeni kwegazi. Kubalulekile ukukwahlula xa wenza ukutshintshwa kwezifo kwiingcibisholo: zeziphi izizathu, kwaye ziphuhliswa ngenxa yenguqu yentsholongwane.