Blood supply of brain

Blood supply of brain

The brain receives its arterial supply from two pairs of

vessels, the vertebral and internal carotid arteries
which are interconnected in the cranial cavity to
produce a cerebral arterial circle or also known as
circle of Willis.

The two vertebral arteries enter the cranial cavity

through the foramen magnum and just inferior to the
pons, fuse to form the basilar artery.

The two internal carotid arteries enter the cranial

cavity through the carotid canals on either side.
 The basilar artery formed by union of two
vertebral arteries, ascends in groove on anterior
surface of Pons.

Its branches in a caudal to rostral direction

include the anterior inferior cerebellar
arteries, several small pontine arteries, and
the superior cerebellar arteries.

The basilar artery ends as a bifurcation, giving

rise to two posterior cerebral arteries.
 Entering the cranial cavity each internal carotid artery gives off:

The ophthalmic artery,

The posterior communicating artery,

The middle cerebral artery,

The anterior cerebral artery,

The choroidal artery .

 Ophthalmic artery: arise from internal
carotid arteries. It supplies the eye and other
orbital structures and its terminal branches
supply the frontal area of scalp, the ethmoid
and frontal sinuses and dorsum of nose.
Posterior communicating artery: it's a
small vessel originating close to its terminal
bifurcation. it runs posteriorly above
oculomotor nerve to join the posterior cerebral
artery thus forming circle of Willis.
 Anterior cerebral artery: it is smaller
terminal branch of internal carotid artery. It
supplies the leg area of precentral gyrus.
Middle cerebral artery: it is the largest
branch of internal carotid. it supplies all motor
area except the leg area.
Choroidal artery: it's a small branch of
internal carotid artery that gives off numerous
small branches to surrounding structures (crus
cerebri, lateral geniculate body, optic tract ).
Branches off the vertebral artery

The meningeal branches: supply bone and

Dura in posterior cranial fossa.

The Posterior spinal artery: it supplies

posterior 1/3 of spinal cord.

The anterior spinal artery: it supplies anterior

2/3 of spinal cord.
The posterior inferior cerebellar artery:
largest branch of vertebral artery. it supplies
cerebellar hemisphere, inferior vermis ,etc.

The medullary arteries: its very small

branches that distributed to medulla
oblongata.
Basilar artery branches
The pontine arteries
The labyrinthine artery
The anterior inferior cerebellar artery
The superior cerebellar artery
The posterior cerebellar artery
Circle of Willis
Circle of Willis lies in interpeduncle fossa at base
of brain.
It is formed by anastomosis between two internal
carotid arteries and two vertebral arteries
(anterior communicating, anterior cerebral,
posterior communicating, posterior cerebral and
basilar artery contribute to the circle).
It allows blood that enters by either internal
carotid or vertebral arteries to be distributed to
both cerebral hemisphere.
 In case one of the supply arteries is occluded, the
Circle of Willis provides interconnections between
the anterior and the posterior cerebral circulation
along the floor of the cerebral vault, providing
blood to tissues that would otherwise become
ischemic. (Normally not too much blood flow,
could be served as alternative route if one of the
artery in occluded).

Common site for aneurysms: terminal part of

internal carotid artery ,anterior communicating
artery ,proximal of middle cerebral artery .
 Arteries to Specific Brain Areas

The corpus striatum and the internal capsule are

supplied mainly by:

- medial and lateral striate central branches of middle

cerebral artery

- Central branches of the anterior cerebral artery

supply remainder of these structures.
 The thalamus is supplied mainly by branches
of the posterior communicating, basilar,
and posterior cerebral arteries.

The mid brain is supplied by posterior

cerebral, superior cerebellar and basilar
arteries.

The Pons is supplied by basilar and anterior

inferior and superior cerebellar arteries.
 The medulla oblongata is supplied by
vertebral, anterior and posterior spinal,
posterior inferior cerebellar and basilar
arteries.

The cerebellum is supplied by superior

cerebellar, anterior inferior cerebellar and
posterior inferior cerebellar arteries.
Cerebral circulation

The blood to brain must deliver oxygen, glucose

and other nutrients to nervous tissue and remove
carbon dioxide ,lactic acid and other metabolic by-
products.

The amount of blood that the cerebral circulation

carries is known as cerebral blood flow.

The arterial cerebral circulation is normally

divided into anterior cerebral circulation and
posterior cerebral circulation .
 The anterior and posterior cerebral circulations
are interconnected via bilateral posterior
communicating arteries.

They are part of the Circle of Willis, which

provides backup circulation to the brain .

There are two main pairs of arteries that supply

the cerebral arteries and the cerebrum:
internal carotid artery and vertebral artery
 Anterior cerebral circulation: The anterior
cerebral circulation is the blood supply to the
anterior portion of the brain. It is supplied by
Internal carotid arteries
Anterior cerebral artery (ACA)
Middle cerebral artery (MCA)
 Posterior cerebral circulation: The posterior
cerebral circulation is the blood supply to the
posterior portion of the brain, including the
occipital lobes, cerebellum and brainstem. It is
supplied by the following arteries:
Vertebral arteries: primarily supply the
shoulders, lateral chest and arms.

Basilar artery: Supplies the midbrain, cerebellum.

Posterior cerebral artery (PCA)

Posterior communicating artery.

Cortical areas and their blood supply
 What Happens When Cerebral
Circulation is Impaired?
 Stroke
Cerebral hemorrhage
Hypoxia
Cerebral edema
 Risk Factors for Poor Cerebral
Circulation:
high blood pressure
being overweight
smoking and drinking alcohol
heart disease or atherosclerosis (hardening of
the arteries)
diabetes
high cholesterol
having a family history of heart or disease
Blood supply of spinal cord
The spinal cord receives its arterial supply
from three small arteries: Two posterior spinal
arteries and one anterior spinal artery.

Posterior spinal artery: posteriorly, there are

paired posterior spinal arteries, which are fed
by smaller radicular arteries at nearly every
spinal level.
 Anterior spinal artery:
single artery runs in the ventral midline from
foramen magnum to the filum terminale .
artery is supplied by series of 5-10 unpaired
radicular arteries thatoriginate from vertebral
arteries & aorta and its branches .
 Segmental spinal arteries: Segmental Arteries of the
vertebral column supply radicular arteries. In thoracic
and lumbar regions segmental arteries are known as
intercostal and lumbar arteries which arise from
posterioraspect ofaorta.

Anterior medullary Artery of Adamkiewic: arise of aorta

in lower thoracic or upper lumbar vertebral levels. It is
unilateral and enters spinal cord from left side in
majority.
It is major source of blood to the lower 2/3 of spinal cord