Blood Supply of the

Central Nervous System

Ma. Cristina S. Elma, MD, FPOGS
Department of Anatomy, UERMMMC

Objectives

Describe the origin and course of the arterial

blood supply of the brain:

Internal carotid artery system

Vertebral artery system
Circle of Willis

Describe the general distribution of the

different branches of arteries that supply the
various regions of the brain
Describe the venous drainage of the brain
Describe the arterial supply and venous
drainage of the spinal cord

The Brain

One of the most metabolically active

organs of the body consuming large
amounts of oxygen and glucose
requires continuous blood flow
Arterial supply consists of 2 major
interconnected systems:

Internal Carotid System

Vertebral Artery System

QUESTION

GIVE ONE OF THE TERMINAL

BRANCHES OF THE INTERNAL
CAROTID ARTERY.

Internal Carotid Artery

Major Intracranial Branches

Hypophyseal arteries
Ophthalmic artery
Posterior
communicating
artery
Anterior choroidal
artery
Anterior cerebral
artery (ACA)
Middle cerebral
artery (MCA)

Middle Cerebral Artery

Direct communication of the ICA

Supplies the dorsolateral surface of the
cerebral hemispheres
Branches from stem (or M1):

Lateral striate arteries (part of the

lenticulostriate arteries)

Superior (upper or suprasylvian) MCA

branch
Inferior (lower or infrasylvian) MCA branch

QUESTION

GIVE A FUNCTIONAL/BRODMANN AREA

SUPPLIED BY THE MIDDLE CEREBRAL
ARTERY.

Key Functional Areas [MCA]

Superior branches

Sensorimotor cortex (except legs)

Frontal eye fields
Brocas area (language expression)

Inferior branches

Wernickes area (language comprehension)

Auditory cortex
Optic radiations

OCCLUSION MAY PRODUCE:

Severe contralateral hemiparesis

(marked in UE and face)
Contralateral sensory loss mainly the
face and the arm
Severe aphasia (if dominant hemisphere
is involved)

Anterior Cerebral Artery

Anterior branch of ICA supplying the

medial aspect of the frontal and
parietal lobes
Branches:

Anterior communicating artery

Orbital branches and frontopolar artery
Callosomarginal artery
Pericallosal artery
Medial striate artery (or recurrent artery
of Heubner) [part of the lenticulostriate

arteries]

Key Functional Areas [ACA]

Septal area
Sensorimotor cortex for the
lower extremities
Motor planning areas in the
medial frontal lobe

OCCLUSION MAY PRODUCE:

Contralateral hemiparesis and

hemisensory loss greatest in the lower
limb
Inability to identify objects correctly,
apathy and personality changes (frontal
and parietal lobes)

QUESTION

WHAT ARTERY GIVES RISE TO THE

ANTERIOR AND POSTERIOR SPINAL
ARTERY?

Vertebral Artery System

Vertebral artery

Spinal arteries- 2 posterior and 1 anterior

Posterior inferior cerebellar arteries (PICA)
Medullary (bulbar) branches

Basilar artery

Anterior inferior cerebellar arteries (AICA)

Internal auditory (labyrinthine) arteries
Pontine arteries- paramedian, circumferential
(short and long)
Superior cerebellar arteries
Posterior cerebral arteries (PCA)

QUESTION

NAME THE ARTERIAL SUPPLY OF THE

PRIMARY VISUAL CORTEX.

Posterior Cerebral Artery

Terminal branch of the basilar artery

Supplies the midbrain, the inferior
aspect of the cerebral hemispheres and
the occipital lobe
Branches:

Calcarine artery
Posterior choroidal arteries
Deep perforating branches

Key Functional Areas [PCA]

Diencephalon
Midbrain
Primary visual cortex
Hippocampal formation
(memory)

OCCLUSION MAY PRODUCE:

Contralateral homonymous hemianopsia

Bilateral occlusion: defect of memory

Circle of Willis

Also called circulus arteriosus

Formed by the junction of the basilar
artery and the 2 ICAs through the
presence of 2 posterior and 1 anterior
communicating arteries
Little exchange between brain halves
(functionally separate): equalize flow
but functionally inadequate

Arteries to Specific Brain Areas

Corpus striatum and internal capsule:

lenticulostriate and anterior choroidal arteries

Thalamus: PCA, posterior communicating, and basilar

arteries

Midbrain: PCA, superior cerebellar, and basilar arteries

Pons: basilar artery, superior cerebellar arteries, AICA
and PICA

Medulla oblongata: vertebral, anterior and posterior

spinal, PICA, and basilar arteries

Cerebellum: superior cerebellar artery, AICA, and

PICA

1. Anterior cerebral artery

(callosomarginal and
pericallosal arteries)
2. Middle cerebral artery
3. Posterior cerebral artery
4. Medial striate arteries to
the internal capsule,
globus pallidus and
amygdala
5. Lateral striate arteries to
the caudate nucleus,
putamen and internal
capsule

MIDDLE MENINGEAL ARTERY

Periosteal branch of the

external carotid artery
supplies no CNS tissue
enters the cranial cavity
through the foramen
spinosum
usually ruptured by
fracture of the lateral
skull vault
bleeding between the
dura and overlying
skull(extradural or
epidural hematoma)

QUESTION: TRUE OR FALSE

THE CEREBRAL VEINS RUN PARALLEL

WITH THE CEREBRAL ARTERIES.

Venous Drainage of the Brain

Cerebral Veins

External cerebral veins

Superior cerebral veins
Superficial middle cerebral
vein
Deep middle cerebral vein

Basal veins
from anterior cerebral,
striate and deep middle
cerebral veins and empty
into the great cerebral vein

Internal cerebral veins

from thalamostriate, septal
and choroidal vv.

Great cerebral vein of Galen

formed by the 2 internal
cerebral veins and empty
into the straight sinus

Venous Drainage of the Brain

Dural Venous Sinuses

Superior sagittal sinus

Inferior sagittal sinus
Rectus (straight) sinus
Confluence of the sinuses
Transverse sinuses
Sigmoid sinuses
Cavernous sinus

The Spinal Cord

Blood supply: perforating vessels from

network of pial arteries

Spinal cord: 1 anterior and 2 posterior

spinal arteries
Nerve roots: radicular arteries
Cord and roots: radiculospinal or
segmental medullary arteries

Great anterior
segmental medullary
artery of Adamkiewicz

QUESTION

THE DORSAL HORN OF THE SPINAL

CORD IS SUPPLIED BY WHAT ARTERY?

HAPPY HEARTS DAY!!!!!

Quiz
Write your name, section, and
todays date on the half sheet
of paper provided.

QUIZ
6. What is the arterial supply of Brodmann
area 4?
7. Give one artery supplying the cerebellum.
8. Give one sinus that drains into the
confluence of sinuses.
9. Give ARTERY that supplies the internal
capsule.
10. What artery supplies the ventral horn of
the spinal cord?