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Anastomosis Left Anterior Cerebral Artery Blockage

Anastomosis Left Anterior Cerebral Artery Blockage

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Published by: mcwnotes on Jan 28, 2009
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Arterial Blood Supply to the Brain
The arterial blood for the brain enters the cranial cavity by way of two pairs of large vessels: the
internal carotid arteries,
which branch off the commoncarotids, and the
vertebral arteries,
which arise from the subclavian arteries. The vertebral arterial system supplies the brain stem, cerebellum, occipital lobe,and parts of the thalamus, and the carotids normally supply the remainder of the forebrain.
Branches of Internal Carotid Artery
ArteryLocation/pathPart of brain it suppliesSymptoms of infarct
Opthalmic arteryPosterior CommunicatingArteryThe
posterior communicatingarteries
join the middlecerebral arteries to the posterior cerebral arteries, which are partof the basilar artery system.Optic chiasm, parahippocampal gyrus,interpeduncular region, crus cerebri andthalamusAnterior ChoroidalArteryCarries blood to the choroid plexus of thelateral ventricles as well as to adjacent brainstructures (hippocampus)Blockages in these arteries can affect the production of cerebrospinal fluid and can alsocause memory problems*Anterior CerebralArteryThe ACAs run medially thenenter the longitudinal fissure.They curve posteriorly and runalong the corpus callosum(
.) and cingulatedgyrus (
.)Linked by the Anterior Communicating Artery
The two anterior cerebral arteries usuallymeet over a shortdistance in midplane toform a short butfunctionally important
This vesselThe
anterior cerebral artery
supplies theanterior frontal lobe and the medial aspect of the hemisphere (frontal and parietal lobes,cingulated gyrus).It supplies blood to the medial cortex,including the medial aspect of the motor stripand the sensory strip.Perforating branches supply the basal ganglia.In a stroke affecting the territory irrigated by theanterior cerebral artery, weakness is most pronounced in the contralateral leg.Damage to the anterior cerebral artery can causesensory and motor impairment in the lower body.For example, a patient who has had a strokeaffecting this artery may be incontinent or haveunilateral paralysis from the hips on down.A blockage in this artery can affect cognition andcause motoric problems due to damage to fibersin the internal capsule or to the basal ganglia.
forms an anastomosis between the left andright hemispheres,which is especiallyimportant when oneinternal carotid becomes occluded.Loops forward around the opticchiasm forming the anterior  portion of the cerebral arterialcircle of Willis.*Middle CerebralArteryThe MCAs run laterallythrough the lateral cerebralfissure of Sylvius giving off 
lenticulostriate aa
. In thelateral cerebral fissure, theMCAs bifurcate into
superiorand inferior divisions
The central branches of themiddle cerebral are the medialand lateral striata arteries.The
middle cerebral artery
supplies manydeep structures and much of the lateral aspectof the cerebrum.This large artery has tree-like branches that bring blood to the entire lateral aspect of eachhemisphere. This means that this arterysupplies blood to the cortical areas involved inspeech, swallowing and language, includingthe lateral motor strip, lateral sensory strip,Broca's area, Wernicke's area, Heschl's gyrus,and the angular gyrus. In addition, it providesmost of the blood supply to the corpusstriatum.The striata supply the basal ganglia, internalcapsule, and thalamusIn a stroke affecting the territory of the middlecerebral artery, weakness and sensory loss aremost severe in the contralateral face and arm, butthe leg may be only mildly affected or unaffected.If a patient has a blockage in the middle cerebralartery, it is probable that s/he will have
.S/he will probably also have impaired cognitionand
, or numbness, on theopposite side of the body. Problems with hearingand the sense of smell may also result fromdamage to this artery because it supplies thelateral surface of the temporal lobe.Because they are the main blood supply to theinternal capsule, they are called by some the
arteries of stroke
. When something happens tothese arteries, the bottleneck of fibers within theinternal capsule can be damaged, causing manydisabilities. The striata are very thin arteries and blood pressure within it high. For this reason,they are considered by many to be morevulnerable to hemorrhages than to blockages,although occlusion of one of these arteries is themajor cause of classical stroke where pyramidaltract damage results in contralateral hemiplegia.The
anterior communicating artery
joins the anterior cerebral arteries of each hemisphere together.
Branches of Vertebral Artery
The vertebral aa. branch from the subclavian aa., pass through the transverse foramina of the cervical vertebrae and enter the foramen magnum.
ArteryLocation/PathPart of brain it suppliesSymptoms of infarct
Anterior spinal arteryFormed by anastomosing branchesoff the medial aspect of the vertebralarteries.Runs the length of the spinal cord inthe ventral median fissure.Supplies the medial medullaincluding the medullary pyramindsand the anterior 2/3 of the cervicalspinal cordBasilar arteryThe vertebral arteries anastomose toform the
basilar a
. which runs alongthe ventral surface of the pons and birfurcates at the upper border of the pons into two posterior cerebralarteriesSupplies thalamus, midbrain, ponsPosterior Cerebral ArteryBranches off the basilar artery. ThePCAs curve around the midbrain,then branch to supply the medial andinferior surfaces of the temporal andoccipital lobes.Pass anterior to the oculomotor nerveand project laterally toward thetemporal lobes of the cerebrum.Supplies mainly the occipital lobeand the choroid plexuses of the thirdand lateral ventricles and the lower surface of the temporal lobeSupplies the part of the brain found inthe posterior fossa of the skull,including the medial area of theoccipital lobes and the inferior aspects of the temporal lobes. Theyalso supply the midbrain and deliver  blood to the thalamus and some other subcortical structures.Supplies midbrain, posterior parts of the brain (occipital lobe), thalamus,globus pallidusThe posterior inferior cerebellar notonly supplies the cerebellum buttakes blood to the lateral medulla.Blockages in this artery can affectthe sense of smell, and cause cranialnerve damage, as well as visual problems, including visual agnosia,hemianopsia and alexia.Posterior inferior cerebellar arteryBranch off the lateral aspect of thevertebral arteries (inferior to the branching of the anterior spinalSupplies the inferior surface of thecerebellum and the lateral part of therostral medulla

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