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Neurovascular Anatomy.pptx
- 1. Mark Milo Asug,MD VASCULAR ANATOMY
- 2. BLOOD SUPPLY TOTHE BRAIN • 2% of body weight • receives 20% of CO
- 3. CEREBRAL BLOOD FLOW CBFml/100g/min Normal 50 Ischemic Penumbra 8-23 Irreversible neuronal death <8
- 4. CIRCLE OF WILLIS •Anterior Circulation - ICA • Posterior Circulation - Vertebrobasilar System
- 5.
- 6. • C1 -Cervical • C2 - Petrous • C3 - Lacerum • C4 - Cavernous • C5 - Clinoid • C6 - Ophthalmic • C7 - Communicating INTERNAL CAROTID ARTERY SEGMENTS
- 7. • carotid bifurcationto entrance to petrous bone • encircled with postganglionic sympathetic nerves ICA C1 - Cervical
- 8. • ends atthe posterior edge of the foramen lacerum • encircled with postganglionic sympathetic nerves ICA C2 - Petrous
- 9. • pierces durato to become the cavernous segment • BRANCHES • 1. caroticotympanic artery • 2. vidian artery ICA C3 - Lacerum
- 10. • S-shaped course •enters subarachnoid space adjacent to the anterior clinoid • pierces distal dural ring ICA C4 - Cavernous
- 11. • BRANCHES • 1.meningohypophyseal trunk - post. pituitary • 2. ant. meningeal a. • 3. a. to inf portion of cavernous sinus • 4. capsular a. of McConnell - pituitary capsule ICA C4 - Cavernous
- 12. • proximal duralring • distal dural ring ICA C5 - Clinoid
- 13. • distal duralring • proximal to PComA • BRANCHES • 1. ophthalmic a. • 2. superior hypophyseal a. ICA C6 - Ophthalmic
- 14. • proximal toPComA origin • travels b/w CN II and III • bifurcates into ACA and MCA ICA C7 - Communicating
- 15. • BRANCHES • 1.PComA • 2. ant. choroidal a. ICA C7 - Communicating
- 18. ANTERIOR CEREBRAL ARTERY passesbetween Cr. N. II and anterior perforated substance BRANCHES 1. recurrent a. of Heubner 2. medial orbitofrontal a. 3. frontopolar a. 4. callosomarginal a. 5. pericallosal a.
- 19. ANTERIOR CEREBRAL ARTERY passesbetween Cr. N. II and anterior perforated substance SEGMENTS 1. A1 - horizontal/precommunicating 2. A2 - vertical/postcommunicating 3. A3— distal ACA and cortical branches
- 20. ANTERIOR CEREBRAL ARTERY SEGMENTS A1- horizontal/precommunicating • medial lenticulostriate a. - perforators to: • optic nerve • optic chiasm • septum pellucidum • anterior commissure • pillars of the fornix
- 21. ANTERIOR CEREBRAL ARTERY passesbetween CN II and anterior perforated substance Anterior Communicating a. perforators to: • infundibulum • optic chiasm • subcallosal area • preoptic hypothalamus
- 22. ANTERIOR CEREBRAL ARTERY AnteriorCommunicating a. perforators to: • infundibulum • optic chiasm • subcallosal area • preoptic hypothalamus
- 23. ANTERIOR CEREBRAL ARTERY SEGMENTS •A2 - distal ACA and cortical branches BRANCHES 1. Recurrent Artery of Heubner • 2. Orbitofrontal a. • 3. Frontopolar a. • 4. Anterior internal frontal a.
- 24. ANTERIOR CEREBRAL ARTERY •SEGMENTS • A3 - vertical/postcommunicating BRANCHES • Callsomarginal a. • Pericallosal a. • Middle internal frontal a. • posterior internal frontal a.
- 25. ANTERIOR CEREBRAL ARTERY SEGMENTS •A3 - vertical/postcommunicating BRANCHES • paracentral a. • superior parietal a. • inferior parietal a.
- 26. MIDDLE CEREBRAL ARTERY SEGMENTS M1- horizontal segment extends horizontally and laterally beneath the anterior perforated substance, proximal to the bifurcation (50%) or trifurcation (25%).extends horizontally and laterally beneath the anterior perforated substance, proximal to the bifurcation (50%) or trifurcation (25%).
- 27. MIDDLE CEREBRAL ARTERY SEGMENTS M2- insular segment bifurcation to the genu
- 28. MIDDLE CEREBRAL ARTERY SEGMENTS M3- opercular segment opercular branches emerging from the sylvian fissure
- 29. MIDDLE CEREBRAL ARTERY SEGMENTS M4- cortical segments
- 30. MIDDLE CEREBRAL ARTERY SEGMENTS M1- horizontal segment uncal a. temporopolar a. ant. temporal a. lateral lentriculostriate a.
- 31. MIDDLE CEREBRAL ARTERY SEGMENTS M2- insular segment SUPERIOR TRUNK orbitofrontal branch prefrontal branch precentral branch central branch anterior paroetal branch
- 32. MIDDLE CEREBRAL ARTERY SEGMENTS M2- insular segment INFERIOR TRUNK posterior parietal branch angular branch temporo-occipital branch posterotemporal branch middle temporal branch
- 33.
- 34. VERTEBRAL ARTERY arises fromsubclavian artery V1 - subclavian a. to C6 foramina V2 - C6 to C2 transverse foramina V3 - C6 foramina to dural insertion V4 - dural insertion to vertebrobasilar
- 35. VERTEBRAL ARTERY BRANCHES 1. Extracranial 2.Posterior spinal a. 3. Anterior spinal a. 4. PICA
- 36. VERTEBRAL ARTERY Three branches: 1.Segmental spinal branches 2. Muscular branch anastomoses with muscular branch of ECA (ascending pharyngeal, thyrocervical, and costocervical)
- 37. VERTEBRAL ARTERY 3. Meningealbranch Anterior meningeal branch → dura around the foramen magnum Posterior meningeal branch → falx and posterior fossa dura Blood supply to the falx cerebelli = posterior meningeal branches, occipital, ascending pharyngeal, and PICA arteries
- 38. VERTEBRAL ARTERY POSTERIOR SPINALARTERY - gracile and cuneate fasciculi and the inferior cerebellar peduncle ANTERIOR SPINAL ARTERY - pyramid, medial lemniscus, medial longitudinal fasciculus, olive and vagal and hypoglossal nuclei
- 39. VERTEBRAL ARTERY choroid offourth ventricle, posterior lateral medulla, tonsils, vermis, and posteroinferior cerebellar hemispheres
- 40. BASILAR ARTERY BRANCHES AICA Labyrinthine a. Paramediana. Pontine a. SCA PCA
- 41. POSTERIOR CEREBRAL ARTERY SEGMENTS P1- precommunicating segment - tip of basilar a. to PComA P2 - ambient segment - PCommA to dorsal aspect of midbrain
- 42. POSTERIOR CEREBRAL ARTERY SEGMENTS P3- quadrigeminal segment lateral portion of quadrigeminal cistern to anterior limit of calcarine fissure P4 - terminal cortical branches
- 43. POSTERIOR CEREBRAL ARTERY P1SEGMENT posterior thalamoperforator a. medial posterior choroidal a. meningeal branches
- 44. POSTERIOR CEREBRAL ARTERY P2SEGMENT lateral posterior choroidal a. thalamogeniculate a. cortical branches
- 45. POSTERIOR CEREBRAL ARTERY P3SEGMENT posterior temporal a. internal occipital a. parieto-occipital a. calcarine a. posterior pericallosal a.
- 46.
- 47.