BACKGROUND The COWs is a vascular anastomosis situated near the base of the brain.The association between structural changes in the COW& cerebral infarction is contentious. Aim of our study was “to evaluate the association between anatomical variations in the COWs & occurrence of different patterns of brain infarct”. MATERIAL & METHODS The present cross-sectional study was conducted at Department of Radiology of a tertiary care center among 500 patients of suspected cerebrovascular accidents during the study period of one year.Complete history of patients was taken. The following variations in the COW on MRA were recorded: pfPCA, cfPCA& aplasia or hypoplasia of PCoA.The statistical analysis was conducted using SPSS version 25.0. RESULTS 240 (48%) had infarction while 260 (52%) patients did not have infarction.fPCA was present in 50 (20.8%) patients while aplasia or hypoplasia of communicating artery was present in 182 (75.8%) of patients. Subgroup analysis of the infarcted territory indicated no significant difference between those with & without fPCA& hypoplasia of PCoA.No significant association was found between fPCA& hypoplasia of PCoA& clinical danger factors of CVD in patients with infarction. CONCLUSION This study demonstrated no significant relationship between particularchanges in the COW but gives a sign of vulnerability to silent cerebral vascular infarction.

Brain Infarction, Cerebral Artery, Cerebrovascular Disease,COWs, Communicating Artery, MRAngiogram.