Normal variants: Complete Circle of Willis

The Circle of Willis has great variation. A complete Circle of Willis is seen in only approximately 21% of autopsy cases. 

AP left internal carotid angiogram 

This injection was performed in preparation for a Wada test on a 17 year old female with intractable epilepsy. There was filling of the entire basilar artery, both posterior cerebral arteries, the distal left vertebral artery, and significant cross-filling to the right anterior and middle cerebral arteries. 

After a test injection (at a very slow rate) opacified only the left anterior, middle and posterior cerebral arteries,  the sodium Amytal was administered without complication.

 
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