Dr.

Mohammed Ashraf,MD
Lecturer of radiodiagnosis

sinaiuniversity.net
 Lecture 2
Cerebral Vascular
Radiological Anatomy &
Ischemic Stroke
By
Dr. Mohammed Ashraf, MD
Lecturer of Radiodiagnosis
Arterial Supply Of Brain

Arterial Suppley

Anterior Psoterior

Vertebrobasilar
Carotid system system
 Circle of Willis

 Definition:polygon of arterial anastomosis

formed by the ICA & posterior circulation on
each side.
 Site: suprasellar & interpeduncular cisterns.
 Circle of Willis

 Definition: polygon of arterial

anastomosis formed by the ICA &
posterior circulation on each side.
 Circle of Willis
 Site: suprasellar &
interpeduncular cisterns.
 Circle of Willis

 Anterior circulation

o left and right internal carotid arteries (ICA)

o horizontal (A1) segments of the left and right anterior cerebral arteries (ACA)
o single anterior communicating artery (ACOM)
 Circle of Willis

 Posterior circulation

o left and right posterior communicating arteries (PCOM).

o horizontal (P1) segments of the left and right posterior cerebral arteries (PCA).
o single Basilar tip artery .
Circle of Willis
MRA of Circle of Willis
3D CT of Circle of Willis
CT of Circle of Willis
Blood arterial territories:
Venous Drainage Of Brain

Venous drainge

Superficial Deep
Middle cerebral
V.
Venous
sinuses
Superior
anastomotic V.

Inferior
anastomotic V
Venous Drainage Of Brain
Venous Drainage Of Brain (MRV)
Venous Drainage Of Brain (MRV)
1 minute
 Stroke
 Definition: sudden loss of certain brain function due
sudden complete cut off its blood / oxygen supply.

 Types:
→ Ischemic
→ Hemorrhagic
 Ischemic Stroke
 CT in ischemic stroke :
 On the proper clinical setting, CT is the first step to exclude hemorrhage.

 Important CT findings in ischemic stoke: May appears within 24 hours.

 Picture of cytotoxic edema: Hypodensity with loss of grey- white matter interface.
Cortical and subcortical involvement.
 May be associated with Hyperdense artery sign.
 Follow vascular territory.
 Ischemic Stroke
 CT is ischemic stroke :
 Ischemic Stroke
CT is ischemic stroke :
 Ischemic Stroke
 MRI in ischemic stroke :

 Hyperacute (< 6h): retsricted diffusion

 Acute: low T1, high T2 & FLAIR signal .
 Old : Low T1, high T2 & low FLAIR signal

 Follow vascular territory.

 Ischemic Stroke
 MRI in ischemic stroke :
 Hyperacute (< 6h): retsricted diffusion
 Ischemic Stroke
 MRI in ischemic stroke :
 Acute: high T2 & FLAIR signal
 Ischemic Stroke
 MRI in ischemic stroke :
 Old : High T2 & low FLAIR signal
Quiz??
Quiz??
THANK YOU

For any questions feel free

to contact me by mail
Mohamed.abdelmoanim@su.edu.eg

Dr.Mohammed Ashraf,MD
LECTURER OF RADIODIAGNOSIS