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Blood supply of the brain

• The blood supply to the brain is supplied by 4 arteries: 2 vertebral arteries and 2 internal
carotid arteries.
• The 2 vertebral arteries go into the skull via the foramen magnum and link at the lower
border of the pons to create the basilar artery, which ascends in the midline on the ventral
surface of the pons and at its upper border ends by dividing into left and right posterior
cerebral arteries.
• Every internal carotid artery enters the cranial cavity via carotid canal and the superior part
of the foramen lacerum. It then takes a sinuous course via the cavernous sinus, pierces the
dural roof of the sinus and finishes immediately lateral to the optic chiasma in the region
of anterior perforated substance by breaking up into a bigger middle cerebral artery and a
smaller anterior cerebral artery.

• Circle of Willis (Circulus Arteriosus)
- The branches of basilar and internal carotid arteries anastomose at the base of brain
around the interpeduncular fossa creating a 6 -sided polygon of arteries termed circulus
arteriosus or circle of Willis. The circle of Willis is located in the interpeduncular
subarachnoid cistern and gives the majority of the arterial blood supply to the brain.

• The circle of Willis is composed:

- Anteriorly, by the anterior communication and the anterior cerebral arteries.
- Posteriorly, by the basilar artery splitting into 2 posterior cerebral arteries.
- Laterally on every side, by the posterior communicating artery joining the internal
carotid artery with the posterior cerebral artery.

• Function of circle of Willis:

- Normally there’s little or no mix of blood streams of (a) 2 vertebral arteries in the
basilar artery, (b) 2 anterior cerebral arteries in the anterior communicating artery
and (c) internal carotid and posterior cerebral arteries in the posterior
communicating artery. For that reason, right half of the brain is supplied by right
vertebral and right internal carotid arteries and left half of the brain is supplied by
left vertebral and left internal carotid arteries.
- But if 1 of the major arteries creating the circle of Willis is obstructed, the circle
of Willis gives the different alternative routes for collateral circulation like an
arterial traffic circle.
Branches of the Cranial Part of Vertebral Artery

All these are as follows: ‫اسامي بس‬

- Posterior spinal artery (first intracranial branch) appears from vertebral artery and
occasionally from posterior inferior cerebellar artery. It enters downwards on the
posterior surface of the spinal cord after breaking up into 2 branches; 1 along the
medial side and the other along the lateral side of the dorsal roots of the spinal
- Posterior inferior cerebellar artery is the largest branch of the cranial (4th) part
of the vertebral artery. It originates near the lower end of the olive, winds backwards
around the medulla oblongata and after that ascends to the pontomedullary junction.
- Anterior spinal artery is a small branch. It appears near the conclusion of the
vertebral artery. It descends in front of the medulla and unites with its fellow of the
opposite side-the lower end of the olive to create one median trunk that descends
along the anterior longitudinal fissure of the spinal cord.
- Meningeal branches are small and supply the dura mater of the posterior cranial
- Medullary arteries are several tiny vessels which supply the medulla oblongata.

Branches of the Basilar Artery

All these are as follows: ‫اسامي بس‬

- Pontine branches are numerous short, slim paramedian vessels, which pierce the
pons to supply it.
- Anterior-inferior cerebellar artery appears close to the lower border of the pons
and run backwards and laterally normally ventral to the 7th and 8th cranial nerves.
Afterward it creates a loop over the flocculus of the cerebellum and peeps into the
internal acoustic meatus for a varying space being located below the 7th and 8th
cranial nerves. After exit from the meatus, it supplies the anterolateral portion of
the inferior outermost layer of the cerebellum.
- Labyrinthine artery is a long slim branch which originates either from basilar
artery or from anterior-inferior cerebellar artery. It accompanies the
vestibulocochlear nerve and enters the internal auditory meatus to supply the
internal ear.
- Superior cerebellar artery appears near the superior border of the pons, runs
laterally below the oculomotor nerve (that is interposed between this artery and the
posterior cerebral artery) and winds round the cerebral peduncle below the trochlear
nerve to get to the superior outermost layer of the cerebellum, which it supplies.
- Posterior cerebral artery enters laterally along the superior border of the pons
parallel to the superior cerebellar artery, curves around the midbrain to get to the
medial surface of the cerebral hemisphere below the splenium of corpus callosum.
The artery produces central branches into the ventral outermost layer of the
midbrain and temporal lobe of the corresponding cerebral hemisphere. Afterward it
enters in the direction of the occipital post supplying cortical branches.
Branches of the Cerebral Part of Internal Carotid Artery ‫مش مهم‬

All these are as follows:

- Ophthalmic artery originates from internal carotid artery immediately after it
comes out of cavernous sinus and makes a U-shaped curve. The ophthalmic artery
enters the orbit via optic canal to supply structures of the orbit consisting of eyeball.
- Posterior communicating artery originates near the conclusion of the interna l
carotid artery. It runs backwards and anastomoses with the proximal part of the
posterior cerebral artery.
- Anterior choroidal artery is a long thin branch, which originates just distal to the
origin of the posterior communicating artery. It lessons backwards above and along
the optic tract to go into the inferior horn of the lateral ventricle via the choroid
fissure to finish in the choroid plexus.
- Because of its long subarachnoid course and a comparatively small lumen, the
anterior choroidal artery is the most prone to thrombosis and is frequently called
artery of cerebral thrombosis.
- Anterior cerebral artery is a smaller terminal branch of the internal carotid artery. It
runs forwards and medially above the optic nerve to the commencement of the
median longitudinal cerebral fissure, where it comes quite close to its fellow of the
opposite side and gets joined with it by a brief transverse anterior communica ting
artery. The anterior cerebral artery then arch around the genu of corpus callosum.
- The branches given off just distal to the anterior communicating artery supply the
medial part of the orbital surface of the frontal lobe.
- The artery continues along the upper surface of the corpus callosum and supplies
branches which supply all of the medial surfaces of the hemisphere above the corpus
callosum as much back as the parieto-occipital sulcus. 5. Middle cerebral artery is
the bigger terminal branch of the internal carotid artery. It seems to be the direct
continuation of the internal carotid artery and carries about 30% of the carotid blood
- The middle cerebral artery first runs laterally in the stalk of the lateral sulcus and
after that turns backwards and upwards in the posterior ramus of the lateral sulcus,
where it breaks up into frontal, parietal and temporal branches, which come from
the lateral sulcus and run in the direction of the regions of their supply.
- It’s been noticed that every principal artery supplying the brain produces 5 sets of
branches, hence making a total of 15 sets, out of which there are 3 pairs of cerebral
arteries (anterior, middle and posterior) and 3 pairs of cerebellar arteries
(posteroinferior, anteroinferior and superior).

Arterial Supply of Cerebrum

- The cerebrum is supplied by 3 pairs of cerebral arteries, anterior, middle and

• Branching Pattern of Cerebral Arteries
• The cerebral arteries give 3 types of branches,

- Cortical branches.
- Central branches.
- Choroidal branches.