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Arteries of brain
- 1. Blood supply of brain
- 2. Arteries supplying Brain • Brain needs continuous arterial supply • If there is block for • More than 5 minutes • Neurons will die • Brain uses • 20 % of inspired Oxygen
- 3. Arteries supplying Brain • Provided by Two Systems • Anterior and posterior systems • Anterior system (circulation) • Carotid System • Supply anterior portion of the brain • Posterior system (circulation) • Vertebro-Basilar System • Supply posterior portion of the brain • Anterior and posterior circulations are interconnected via • Posterior communicating arteries
- 4. Arteries supplying Brain • From • Internal carotid artery • From Common carotid • Left from arch of aorta • Right brachiocephalic • Vertebral artery • From subclavian • Arteries supplying brain are lying • Within subarachnoid space
- 5. Branching pattern of cerebral arteries • 2 types • Central & cortical • Central • Supply interior of cerebral hemispheres • Pierces through anterior or posteior perforated substance • End arteries • Form six groups • Antero medial • By anterior cerebral and anterior communicating • Posteromedial • By posterior cerebral & posterior communicating • Anterolateral (rt & Lt) • Middle cerebral • Posterolateral (rt & lt) • Postrior cerebral
- 6. Branching pattern of cerebral arteries • Cortical branches • They form anastomosis • But they become end arteries after enters the substance • 2 groups • Long cortical • Also known as medullary • They pass through cortex to white matter • Short cortical • Restricted to cortex • Form network in middle zone of cotes • Outer & inner zones are least arterial supply
- 7. Vertebral artery • From • First part of subclavian • Has 4 parts • 1st part • Before entering • 2nd part • Through first 6 foramen transversarium • 3rd part • In suboccipital region • 4th part • Passes through foramen magnum • Within cranial cavity
- 8. Vertebral artery – cranial cavity • IV part Enters cranial cavity • Through foramen magnum • Pierces dura & arachnoid matter • Lies in subarachnoid space • Passes medially anterior to medulla • Till inferior border of pons • Where 2 vertebral arteries join • To form basilar artery
- 9. Vertebral artery cranial part - Branches • Anterior spinal artery • Posterior spinal • Posterior inferior cerebellar • (Largest branch) • Meningeal arteries • Supplies the dura matter of posterior cranial fossa • Medullary arteries • Supplies medulla oblongata
- 10. Anterior spinal artery • Formed by the union of branches from both vertebral arteries • Descend in front of the medulla to reach and supply the spinal cord • Runs caudally • In anterior median fissure • Ends at filum terminale • Supplies • Anterior two third of cord • Enhanced by segmental arteries
- 11. Posterior spinal artery • Either from • Vertebral or Posterior inferior cerebellar arteries • Runs down in posterolateral sulcus • Supplies • Posterior one third of the cord
- 12. Posterior inferior cerebellar artery • Supplies • Medulla • Inferior part of cerebellum • Choroidal branch to fourth ventricle • Sometimes posterior spinal branch
- 13. Basilar artery • 2 vertebral arteries unite • At the junction between medulla and pons • Form basilar artery • Runs the length of the pons and supplies it by pontine branches. • At the junction of pons and midbrain • Divides into • 2 Posterior cerebral arteries
- 14. Basilar artery - branches • Superior cerebellar artery • Pontine branches • Labyrinthine artery • Pass through the internal acoustic meatus - inner ear • Anterior inferior cerebellar artery • Posterior cerebral arteries • At upper pons
- 15. Posterior cerebral artery • Terminal branches of basilar artery • Curves laterally • Around cerebral peduncle • Passes back • To tentorial surface of cerebrum • Separated from • Superior cerebellar artery by • Oculomotor nerve • Connected with ICA by • Posterior communicating artery
- 16. Posterior cerebral artery - branches • Branches can be divided into • Cortical & central • Cortical branches • Supply visual area • Inferior surface • Occipital lobe • Temporal lobe except temporal pole • Superolateral surface • Inferior temporal gyrus • Occipital lobe • Medial surface • Lingual gyrus • Cuneus • Posterior part of precuneus
- 17. Applied anatomy • Occlusion of posterior cerebral artery • Produces hemianopia (contralateral side) (partial blindness)
- 18. Posterior cerebral artery - branches • Central branches • Posteromedial group • Together with branches of posterior communicating artery • Pierces posterior perforated substance • Supplies • Anterior part of thalamus and globus pallidus • Posterior choroidal • Enters inferior horn of lat ventricle • Through choroid fissure • Supplies • Choroid plexus & lateral geniculate body
- 19. Carotid system
- 20. Internal carotid artery • From • Common carotid • Has 4 parts • Cervical • Petrous • Cavernous • Cerebral
- 21. Internal carotid • Enter middle fossa • Through carotid canal (petrous part) • Reach the side of body of sphenoid bone • Turns forward in cavernous sinus (cavernous part) • To reach the medial aspect of anterior clinoid process • Lies lateral to optic chiasma (cerebral part)
- 22. Internal carotid – cerebral part • Branches • Opthalmic • Anterior cerebral • Middle cerebral • Posterior communicating • Anterior choroidal
- 23. Anterior choroidal • Runs backwards • Just below optic tract • Supplies • Crus cerebri • Lateral geniculate body • Globus pallidus • Internal capsule (post limb) • Caudate nucleus • Optic radiation • Enters • Inferior horn of Lateral ventricle • Forms choroid plexus
- 24. Middle cerebral • Largest terminal branch of ICA • Begins at ant perforated substance • Passes in stem of lateral sulcus • Reaches insula • Divides into • Cortical branches • Supplies • Inferior surface • Superolateral surface
- 25. • Inferior surface • Lateral half of orbital surface • Superolateral surface • Entire surface except • Occipital lobe • Small strip of • Superomedial border • Tentorial part of inferolateral border • Medial surface • Temporal pole Middle cerebral artery - Areas supplied by cortical branches
- 26. Middle cerebral artery - Areas supplied by central branches • Lateral striate • Pierces cortex to reach lentiform • Some branches pierce lentiform and supplies • Internal capsule • Artery of Cerebral haemorrhage • One of the lateral striate branches is very large • Liable to rupture due to high BP
- 27. Anterior cerebral • Smaller terminal branch of ICA • Begins at • Stem of lateral sulcus • Passes anteromedially • To reach posterior part of medial orbital border • Where communicated with opposite side artery by • Anterior communicating artery • Reaches medial surface • Curves around the genu • Passes posteriorly on body of corpus callosum • Turns upwards infront of parieto occipital sulcus
- 28. Anterior cerebral - Areas supplied by cortical branches • Cortical branches • Inferior surface • Medial half of orbital surface • Medial surface • Upto parieto-occipital sulcus • Corpus callosum, cingulate gyrus, paracentral lobule & precuneus • Superolateral surface • Strip of cortex along superomedial border upto parieto-occipital sulcus • Upper part of motor & sensory areas (lumbosacral region)
- 29. Anterior cerebral artery – central branches • Piercing anterior perforated substance • Supplies • Head of caudate nucleus • Lentiform nucleus (anterior part) • Rostrum of corpus callosum
- 30. Circle of Willis • An arterial circle situated at the interpeduncular cistern • At base of brain • Encloses • Optic chiasma and structures in interpeduncular fossa • Joins Carotid & Vertebrobasilar systems
- 31. Circle of Willis • Extent • From upper border of Pons • To medial longitudinal fissure • Shape • Polygonal than circular
- 32. Circle of Willis • Formation • Front • 2 anterior cerebral arteries • Joined by anterior communicating artery • Posterior • Basilar artery divides into • Posterior cerebral arteries • On sides • Posterior communicating • Connecting ICA with PCA
- 33. Circle of Willis - Branches • Provide central branches • End arteries • Pierce the brain and supplies deep part • Arranged in groups • They are • Anteromedial group • Anterolateral group • Posterolateral group • Posteromedial group
- 34. Circle of Willis - branches • Anteromedial group • Branches from • Anterior cerebral • Anterior communicating • Piercing anterior perforated substance • Supplies • Preoptic, supraoptic & anterior parts of hypothalamus
- 35. Circle of Willis - branches • Anterolateral group • From • Middle cerebral artery • Pierce • Anterior perforated substance • Supplies • Corpus striatum & internal capsule
- 36. Circle of Willis - branches • Posterolateral group • From • Posterior cerebral artery • Supplies • Posterior part of thalamus • Geniculate bodies • Posteromedial group • From • Posterior cerebral & posterior communicating • Supplies • Anterior part of thalamus • Lateral wall of III ventricle
- 37. Arterial Disorders • Stroke • Blood supply to the brain is interrupted or reduced • Either by • Ischemia • Hemorrhage • Aneurysm • Dilation of the wall (may take years)
- 38. • A weak or thin spot on an artery in the brain bulges • Aneurysm can put pressure on the nerves or brain tissue • Burst or rupture • Leads to hemorrhage