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Arterial Supplies of Brain and Corresponding Clinical Findings - Part 1. 13/05/03 Craig Douglas Nadine MacCowan. Carotid Supply. Right common carotid arises from brachiocephalic trunk Left common carotid branches directly from the aortic arch

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Arterial supplies of brain and corresponding clinical findings part 1

Arterial Supplies of Brain and Corresponding Clinical Findings - Part 1

13/05/03

Craig Douglas

Nadine MacCowan


Carotid supply
Carotid Supply Findings - Part 1

  • Right common carotid arises from brachiocephalic trunk

  • Left common carotid branches directly from the aortic arch

  • The ICA’s ascend through the neck, traverse the temporal bone and pass through the cavernous sinus to reach the subarachnoid space.


Carotid supply1
Carotid Supply Findings - Part 1

  • First intracranial branch is the ophthalmic artery, it travels along the the optic nerve into the orbit. Supplies retina, structures of eyeball and orbit

  • Also gives off post. communicating artery and ant. choroidal artery

  • Finally divides into ant. and middle cerebral arteries

  • The carotid supply provides 600-700 ml of blood every minute to the brain



Vertebral supply
Vertebral Supply Findings - Part 1

  • Vertebral arteries arise from subclavian vessels and course through the cervical transverse foramina. They ascend into the foramen magnum and pierce the dura, entering the cranial cavity to run alongside the medulla

  • They fuse at the junction of the medulla and pons to form the basilir artery

  • Basilir artery gives rise to cerebellar arteries and the post. cerebral arteries

  • Vertebral supply of 100-200 ml/min blood


Vertebral supply1
Vertebral Supply Findings - Part 1


Arterial supply of brain
Arterial Supply of Brain Findings - Part 1


Anterior cerebral artery
Anterior Cerebral Artery Findings - Part 1

  • Arises from ICA at almost a right angle, then runs up over genu of CC

  • Sends deep penetrating branches to supply the ant. portions of the basal ganglia

  • Supplies medial and superior frontal lobe

  • Supplies ant. parietal lobe


Anterior cerebral artery1
Anterior Cerebral Artery Findings - Part 1

  • Supplies:

    -Septal Area

    -Primary motor cortex (leg, foot, ub)

    -Motor planning areas

    -Primary somatosensory cortex

    -Most of corpus callosum


Aca and branches
ACA and Branches Findings - Part 1


Aca and supply
ACA and Supply Findings - Part 1


Basal ganglia
Basal Ganglia Findings - Part 1

  • Consists of caudate nucleus, putamen and globus pallidus

  • Initiates movement

  • Controls movement, by feedback to cerebral cortex

  • Establishes posture

  • Bradykinesia, dystonia and ballismus are common manifestations of disease



Basal ganglia enhanced
Basal Ganglia - Enhanced Findings - Part 1


Corpus callosum
Corpus Callosum Findings - Part 1

  • Main transverse tract of fibres connecting the two cerebral hemispheres

  • Primary functions are to integrate motor, sensory and cognitive performance between the hemispheres

  • Damage may lead to problems with sitting, standing, walking or impaired co-ordination and memory (tactile anomia)


Corpus callosum1
Corpus Callosum Findings - Part 1


Septal area
Septal Area Findings - Part 1

  • The septal area connects the hypothalamus to the mid-brain

  • It is believed to be involved in the integration of complex behavioural and motivational processes

  • Possible role in alterations of behaviour


Motor cortex
Motor Cortex Findings - Part 1


Posterior circulation
Posterior Circulation Findings - Part 1


Posterior communicating artery
Posterior Communicating Artery Findings - Part 1

  • Passes posteriorly and inferiorly to the optic tract

  • Joins posterior cerebral artery

  • One of the anastomosing branches that completes the Circle of Willis

  • It is part of a clinically important collateral blood supply

  • A common site for aneurysms


Posterior cerebral artery
Posterior Cerebral Artery Findings - Part 1

  • Curves around midbrain and passes through superior cistern

  • Also gives rise to several posterior choroidal arteries


What does the posterior cerebral artery supply
What Does The Posterior Cerebral Artery Supply? Findings - Part 1

  • Medial and inferior surfaces of occipital and temporal lobes

  • Including hippocampus, midbrain and thalamus


Posterior cerebral artery and strokes
Posterior Cerebral Artery And Strokes Findings - Part 1

  • About 5% of ischaemic strokes involve the posterior cerebral artery or its branches

  • Death is uncommon

  • Rate of morbidity is high


Symptoms and signs of a posterior cerebral artery stroke
Symptoms and Signs Of A Posterior Cerebral Artery Stroke Findings - Part 1

  • Visual changes

  • Memory problems

  • Dyslexia/Alexia

  • Thalamic/subthalamic nuclei involvement

  • Cerebral peduncle involvement

  • Brainstem involvement


Visual changes
Visual Changes Findings - Part 1

  • Homonymous hemianopia – from unilateral infarction

  • Cortical blindness

  • Lack of depth perception

  • Failure to see objects not centred in visual field

  • Visual hallucinations

  • Disorders of colour vision


Memory problems
Memory Problems Findings - Part 1

  • Infarction of medial temporal lobe or medial thalamic nuclei

  • Usually short term memory affected

  • Right sided stroke: more likely to have difficulties with verbal memory

  • Left sided stroke: more likely to have difficulties with visual memory


Dyslexia alexia
Dyslexia/Alexia Findings - Part 1

  • Pure alexia may result from infarction of dominant occipital cortex

  • Patients may retain the ability to work out a word and its meaning if its spelt out


Thalamic subthamalic nuclei involvement
Thalamic/Subthamalic Nuclei Involvement Findings - Part 1

  • Infarction of the ventral posterolateral nucleus of the thalamus results in hemisensory loss – common in lacunar infarcts

  • Mild hemiparesis

  • Intention tremor


Cerebral peduncle involvement

Hemiplegia Findings - Part 1

Hemiparesis

Oculomotor nerve deficit

Cerebral Peduncle Involvement


Brainstem involvement
Brainstem Involvement Findings - Part 1

  • Pupillary dilatation and dysfunction (especially in PCA aneurysms)

  • Nystagmus due to lateral medullary syndrome


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