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CEREBRAL VASCULAR SUPPLY

CEREBRAL VASCULAR SUPPLY. General Information. Brain receives 20% of the cardiac output. Major arterial supply via: Internal carotids: Give off paired anterior cerebral arteries. Give off paired middle cerebral arteries. Vertebral arteries: Join to form unpaired basilar artery.

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CEREBRAL VASCULAR SUPPLY

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  1. CEREBRAL VASCULAR SUPPLY

  2. General Information • Brain receives 20% of the cardiac output. • Major arterial supply via: Internal carotids: Give off paired anterior cerebral arteries. Give off paired middle cerebral arteries. Vertebral arteries: Join to form unpaired basilar artery

  3. Posterior Inferior Cerebellar Aa • Branches of vertebral arteries. • To: Dorsolateral part of medulla Posterior choroid plexus Posterior/inferior parts of cerebellum • Form unpaired anterior spinal artery. • Form basilar artery.

  4. Basilar Artery Branches • Anterior inferior cerebellar artery To upper medulla and pons • Internal auditory artery To part of inner ear • Pontine arteries To pons • Superior cerebellar artery • Terminate as posterior cerebral arteries

  5. Posterior Cerebral Arteries • Terminal branches of basilar artery. • To: Medial and inferior surfaces of the temporal and occipital lobes, posterior thalamus.

  6. Posterior Cerebral Arteries • Occlusion results in thalamic syndrome: • Contralateral diminishing of general somatic modalities in head (ventral posterior nucleus). • Threshold for pain, temperature, and tactile sensation on contralateral side of head raised. • Mild stimuli may produce disagreeable sensations.

  7. Middle Cerebral Branches • Largest branches of internal carotid arteries. • Run between temporal and frontal lobes. • To most of lateral surfaces of cerebrum. • Give off striate arteries: To internal capsule and adjacent structures. Stroke: Contralateral upper motor-neuron paralysis of face and UE/LE as well as sensory disturbances.

  8. Anterior Cerebral Arteries • Branches of internal carotid arteries. • Give off perforating arteries to hypothalamus. • Extend rostrally and then curve upwards and backwards around corpus callosum: Pericallosal arteries • Occlusion: Contralateral paresis and diminished sensitivity in LE.

  9. Circle of Willis • Interconnects vertebral and internal carotid supply. • Components: Posterior cerebral arteries Posterior communicating arteries Internal carotids Anterior cerebral arteries Anterior communicating artery

  10. Watershed Areas • Border zones of cerebral arteries. • Decreased blood supply. • Hypoperfusion may result in: Paralysis/sensory loss bilateral UE Disturbed vision Disturbed memory Chorea Aphasia

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