Posterior cerebral circulation - Gross Anatomy


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Gross anatomy of the posterior cerbral circulation

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Posterior cerebral circulation - Gross Anatomy

  1. 1. POSTERIORCIRCULATION Dr D Sudeepta Rao PG-General Medicine DCMS
  2. 2. Vertebrobasilar System Vertebral arteries Basilar artery Posterior cerebral arteries
  4. 4. Blood Supply Upper spinal cord Brain stem Cerebellum Occipital lobe Part of Temporal lobe Thalamus Hypothalamus
  5. 5. Vertebral artery(VA) Subclavian artery Ascend in foramina transversaria Upper six cervical vertebra Enter cranial cavity thro foramen magnum Anterolateral aspect of medulla Divided into 4 parts: V 1 to V 4
  6. 6. DIVISIONS:
  7. 7. “SUBCLAVIAN STEAL”• Subclavian occluded proximal to origin of vertebral.• Leads of reversal in the direction of blood flow in the ipsilateral vertebral artery.• Exercise of ipsilateral arm may increase demand on vertebral flow, leading to posterior circulation TIAs.
  8. 8. Branches of VA Anterior spinal artery ◦ Join at mid medullary level ◦ Descend on ventral midline of spinal cord ◦ Supply triangular area of medulla oblongata
  9. 9. Branches of VA(contd…) Posterior inferior cerebellar artery ◦ Largest branch ◦ Ascends behind the roots of the ix & x cr. Nerves ◦ Turns laterally into cerebellar vallecula ◦ Medial and lateral branches ◦ Supply medulla oblongata dorsal to olivary nucleus & lateral to xii nucleus
  10. 10. Branches of VA(contd…) Posterior spinal artery Arises from pica Minute medullary branches
  11. 11. Branches of VA:
  12. 12. BRANCHES OF VA
  13. 13. Blood supply of Medulla
  14. 14. Basilar artery(BA) Arise at Lower border of pons Extend upto upper border of pons Large median vessel formed by union of vertebral arteries Terminates by dividing into 2 posterior cerebral arteries at the interpeduncular fossa
  15. 15. Branches of Basilar artery Pontine branches Anterior inferior cerebellar artery ◦ Lower part of BA ◦ Labyrinthine artery ◦ Supplies inferior cerebellar surface anterolaterally ◦ Anastomose with PICA ◦ Few branches to inferolateral pons Superior cerebellar artery
  16. 16. Branches of Basilarartery(contd..) Superior cerebellar artery ◦ Distal portion of BA ◦ Oculomotor nerve separates it from posterior cerebral artery ◦ Trochlear nerve laterally
  17. 17. Branches of Basilar artery
  18. 18. Branches of Basilar artery
  19. 19. Branches of Basilar artery
  20. 20. Posterior CerebralArtery(PCA) Terminal branch of basilar artery Surgical nomenclature identifies 3 segments: ◦ P1 basilar bifurcation to post communicating a ◦ P2 portion in perimesencephalic cistern ◦ P3 portion in the calcarine fissure Supplies temporal and occipital lobes ◦ Has cortical and perforate/central branches
  21. 21. PCA: Cortical Branches  Temporal branches usually two supply ◦ Uncus ◦ Parahippocampus ◦ Medial and lateral occipetotemporal gyri  Occipital branches supply ◦ Cuneus ◦ Lingual gyrus ◦ Posterolateral surface of the occipetal lobe
  22. 22. Posterior Cerebral Artery Supplies visual areas of the cerebral cortex Concept of Macular sparring
  23. 23. Posterior Cerebral Artery
  24. 24. PCA: Central branches  Supply subcortical structures  Posteromedial central branches(thalamo perforate) ◦ Ant thalamus, subthalamus, latral wall of third ventricle and globus pallidus  Posterolateral central branches(thalamo geniculate) ◦ Supply peduncle posterior thalamus, MGB, superior &inferior colliculi  Posterior choroidal branch ◦ LGB & ends in the lateral ventricle
  25. 25. PCA: Central branches
  26. 26. Thalamus blood supply
  27. 27. PCA: Cortical Branches
  28. 28. Blood supply of the spinalcord Anterior spinal artery in anterior median fissure Two Posterior spinal arteries in the posterolateral sulcus Arterial vasocorona an arterial plexus in the pia mater
  29. 29. Blood supply of the spinalcord
  30. 30. Main source of blood Main source of blood to spinal arteries Vertebral arteries upto cervical segments Radicular ateries that reach the cord along spinal nerve roots
  31. 31. Main source of blood
  32. 32. THANK YOU