The major arteries supplying the brain and spinal cord are the internal carotid arteries, vertebral arteries, and their branches. The internal carotid arteries enter the cranium and give rise to the anterior and middle cerebral arteries. The vertebral arteries join to form the basilar artery, which branches into the posterior cerebral arteries. These arteries anastomose to form the Circle of Willis, supplying different regions of the brain. The vertebral and basilar arteries also give rise to branches that supply the brainstem and cerebellum. The spinal cord receives blood from the anterior and posterior spinal arteries as well as segmental arteries originating from nearby vessels. Occlusion of cerebral arteries can cause strokes with deficits corresponding to the territory of the occluded vessel

1. BLOOD SUPPLY OF THE
BRAIN & SPINAL CORD
Marami binti Mustapa
Anatomy Unit
FMDH NDUM

2. DESIRED LEARNING OUTCOMES
This lecture will enable you to:
• list the arteries supplying the brain and spinal cord
• explain the different cerebral arteries supplying the different areas of
the cerebral cortex
• describe blood supply of cerebellum
• describe the blood supply of brain stem
• describe the blood supply of spinal cord

3. CONTENTS
• Internal carotid artery & its branches
• Vertebral artery, basilar artery & their branches
• Cerebral arterial circle of Willis, its cortical & striate branches
• Effects of lesion of cerebral arteries
• Blood supplies to the spinal cord

4. ARTERIAL SUPPLIES OF THE BRAIN

5. • Derives from:
• Internal carotid arteries
• Vertebral arteries
Lies within subarachnoid
space

6. INTERNAL CAROTID ARTERIES
• Arises from the common carotid artery
• Ascends vertically from the neck to the base of the
skull
• Enter cranial cavity through carotid canals (temporal
bone)
• Passes through cavernous sinus
• Terminal branches:
• Anterior cerebral arteries
• Middle cerebral arteries

7. vertebral artery
subclavian artery
posterior
cranial fossa
aorta
common
carotid
artery
right and left
internal carotid
arteries
(supply the brain)
middle
cranial
fossa anterior
cranial
fossa

8. VERTEBRAL ARTERIES
• Begins in the root of the neck
• 1st branch of the subclavian arteries
• Passes through the transverse foramina of the 1st six
cervical vertebrae
• At the suboccipital region, it pierce the dura and
arachnoid and pass through foramen magnum
• Unite at the caudal part of the pons to form basilar
artery (VERTEBROBASILAR CIRCULATION)

9. right vertebral
artery
right subclavian
artery
cranial
cavity
right and left
vertebral
arteries
the basilar
artery
C6
aorta

10. The Major Cerebral Arteries

12. Territories of the Major Cerebral
Arteries: Lateral View
Branches of the
Anterior Cerebral
Artery
Branches of the Posterior
Cerebral Artery
Branches of the Middle
Cerebral Artery

13. Branches of
the PCA
Branches
of the ACA
Branches of
the MCA
Territories of the Major Cerebral
Arteries: Medial View

15. Territories of the Major
Cerebral Arteries
Lateral
Medial

16. Central Arteries
4 Groups of Central
Arteries penetrate the
deep brain tissue in the
region of the Circle of
Willis:
Anteromedial group
Anterolateral group
Posterolateral group
Posteromedial group
In addition to the central arteries, the medial striate artery, which is a branch of
the anterior cerebral artery, also supplies many of the anterior deep structures
of the brain (importantly, anterior part of the internal capsule).

17. Central Arteries

18. Arterial Supply: Brain Stem and
Cerebellum
Cerebellum: 3 Arteries
From vertebral arteries:
•Posterior Inferior
Cerebellar artery
From basilar artery:
•Anterior Inferior
Cerebellar Artery
•Superior Cerebellar
Artery

19. Arterial Supply: Brain Stem and
Cerebellum
Brain Stem:
Midbrain: branches
from the termination of
the basilar artery and
initial segment of the
posterior cerebral artery.
Pons: Pontine arteries
Medulla: branches from
anterior inferior
cerebellar artery and
posterior inferior
cerebellar artery.

20. Arterial Supply: Choroid Plexus
From: 4
Lateral view of brain,
including ventricles
View of brain from below,
including circle of Willis
One anterior and two posterior
choroidal arteries on each side
supply the choroid plexus of the
lateral and 3rd ventricles.
Branches from the anterior inferior
cerebellar artery and posterior
inferior cerebellar artery supply the
choroid plexus of the 4th ventricle.

21. ARTERIAL SUPPLIES OF THE SPINAL CORD

22. Venous drainage follows a
similar pattern
Arterial Supply includes:
A. Three major longitudinal
arteries: one anterior spinal and
two posterior spinal arteries that
originate from the vertebral
arteries. These run the length of
the cord.
Anterior Posterior
B. Supplemented by Segmental
arteries derived from vertebral,
deep cervical, intercostal and
lumbar arteries.
C. Radicular arteries that run with
the dorsal and ventral spinal nerve
roots.

23. Anterior Posterior
In most people, a particularly large
radicular artery arises from an
intercostal artery on the left between
T9 and T11. It is called the “great
anterior segmental medullary artery”
or the artery of Adamkiewicz. It often
supplies much of the blood for the
lower spinal cord.

24. The anterior spinal artery supplies approximately
2/3 of the cross-sectional area of the spinal cord.

25. Venous Drainage
• 3 anterior and 3 posterior spinal
veins
• Drained by medullary and
radicular veins
• Join the internal vertebral
venous plexuses in epidural
space

26. CLINICAL RELATIONS
sudden occlusion of a cerebral artery/ rupture of a blood vessel causes bleeding
(cerebral haemorrhage)
Cerebrovascular Accident (Stroke)
Related to carotid artery n its
cerebral branches:
• Contralateral
sensory/motor deficit
• Aphasia (loss of language)
Related to vertebrobasilar
circulation:
• Focal brain stem syndrome (eg:
hypereflexia, ipsilateral
incoordination, contralateral
hemisensory loss etc)
brain infarction (death of brain tissue)