Blood supply of Cerebral cortex

Arterial supply of the brain (central nervous system):

The arterial supply of the brain (central nervous system) conies chiefly from main sources

1. Vertebro basllar system.

2. Internal carotid system.

Vertebrobasilar system It consists of:

1. 4th part of vertebral artery (two).

2. Basilar artery (single).
3. Posterior cerebral artery (two).

Vertebral artery 4th part

Origin; the vertebral artery arises in the neck from 1st part of subclavian artery.
Course & relations:
• The course of vertebral artery is divided Into 4 parts.
• The 1st part: from its origin to the foramen transversarium of
the 6th cervical vertebra.
• The 2nd part: ascends to foramen transversarium of atlas.
• The 3rd part lies in the suboccipital triangle.
• The 4th part: of the artery enters the skull through the
foramen magnum. It ascends on each side of the medulla
oblongata in front of the rootlets of the hypoglossal nerve.
Termination: The two vertebral arteries (right and left) unite
together at the lower border of pons to form a single artery;
basilar artery.

Basilar artery
Origin: At the lower border of Pons by the union of the 2 vertebral
arteries.
Course & relations: It passes on the front of the pons in the midline
(pontine sulcus, groove for basilar artery). The artery is related to
abducent nerve (at its beginning) and occulomotor nerve (at its
termination).
Termination: At the upper border of Pons by bifurcation into the 2
posterior cerebral arteries

Posterior cerebral artery

Origin: The 2 posterior cerebral arteries begin at the upper border
of Pons as the 2 terminal branches of the basilar artery.
Course & relations: The artery passes round the midbrain to reach
the occipital pole of the cerebrum. It sinks Inside the calcarine
sulcus.
Termination: It terminates by dividing into its terminal cortical branches.

Internal carotid system:

• It consists of the intracranial part of the internal carotid artery and its two terminal branches; (the anterior and
middle cerebral) arteries.
Internal carotid artery (intracranial part): The ICA enters the middle cranial fossa by passing through the foramen
lacerum.
Course: the artery has a sinuous course, it first passes forward and then upward, Inside the cavernous sinus, lastely
it pierces the roof of the cavernous sinus and passes backward above it.
• The abducent nerve lies inferolateral to the ICA.
• At the base of the brain (anterior perforated substance) the artery terminates into anterior and middle cerebral
arteries.

Anterior cerebral artery:

• It is the smaller of the 2 terminal branches of the ICA.
• It passes on the medial surface of the brain below the rostrum then in front of genu then backward above corpus
callosum through the callosal sulcus.
• It gives: Cortical branches and Central branches.

Middle cerebral artery:

• It is the larger of the two terminal branches of the ICA,
• It passes through the stem of the lateral sulcus then in the posterior ramus of the lateral sulcus.
• It gives: 1- Central branches.2- Cortical branches.

Cortical branches of the cerebral arteries:

The superolateral surface:

It supplied by middle cerebral artery
except: one finger breadth at the upper
border supplied by the interior cerebral
and the occipital lobe supplied by posterior
cerebral artery.
The medial surface: It Is supplied by
the anterior cerebral artery except the
occipital lobe, (behind the parietal occipital
sulcus) Applied by the posterior cerebral
artery.
The inferior surface: The medial part
of orbital surface Is supplied by anterior
cerebral artery. The temporal pole and
lateral part of orbital surface are supplied
the middle cerebral artery.
The remaining tentorial surface is supplied
by the posterior cerebral artery.
The cerebral arterial circle (of
Willis):
Formed at the base of the brain by the interconnecting vertebrobasilar and internal carotid systems of vessels. This
anastomotic interconnection is accomplished by:
• An anterior communicating artery connecting the left and right anterior cerebral arteries to each other.
• Two posterior communicating arteries, one on each side, connecting the internal carotid artery with the posterior
cerebral artery.
Vancouver references
- 2016. Head&Neck neuroanatomy. 1st ed. Alexandria, pp.112-117.
- Fauci AS, Kasper DL, Braunwald E, Hauser SL, Longo DL, Jameson JL, Loscalzo J: Harrison's Principles
of internal Medicine, 17th Edition: http://www. accessmedicine.com

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