BLOOD SUPPLY OF THE BRAIN

derived from 2 internal carotid and 2 vertebral arteries which lie in the subarachnoid space 4 arteries anastomose on the inferior aspect of the brain forming CIRCLE OF WILLIS (circulos arteriosus)

INTERNAL CAROTID ARTERY

arises from the COMMON CAROTID ARTERY enters skull through carotid canal in the temporal bones (petrous) passes anteromedially through the cavernous sinus divides at medial end of the lateral sulcus
anterior and middle cerebral arteries
anterior circulation of the brain

Branches of ICA
Anterior cerebral arteries
smaller terminal branch of the ICA enters longitudinal fissure connected to the opposite anterior cerebral artery by anterior communicating artery curves over corpus callosum central branch supply deep masses of gray matter w/in the cerebral hemisphere Supply:
cortical branches supply all medial surface of cerebral cortex up to parietooccipital sulcus corpus callosum approximately 1 inch of the frontal and parietal cortex on the superior aspect of their lateral surface (this include the leg area of the precentral gyrus) anterior portions of the basal ganglia and internal capsule

 Middle Cerebral Arteries

largest runs laterally in the lateral sulcusbranch cortical branches supply entire lateral surface of the hemisphere EXCEPT
area supplied by anterior cerebral artery inferolateral surface supplied by posterior cerebral artery occipital pole

supply all motor area except leg area supply parts of the internal capsule and basal ganglia central branches supply deep masses of gray matter within the cerebral hemisphere

 Ophthalmic artery
enters orbit through optic canal, below and lateral to optic nerve supplies the eye, including retina and optic nerve

Choroidal artery
enter inferior horn of lateral ventricle to supply choroid plexus branches may help supply the optic tract, LGB, internal capsule and crus cerebri

Posterior communicating artery

runs backward to join posterior cerebral artery at interpeduncular fossa
deep depression on inferior of midbrain between cerebral peduncles part of the circle of willis

VERTEBRAL ARTERY
branch of the 1st part of the subclavian artery ascends the neck through the transverse foramina of upper 6 cervical vertebrae enters skull through foramen magnum Cranial branches
meningeal arteries anterior and posterior spinal arteries posteroinferior cerebellar artery
largest branch of the vertebral artery and supplies parts of the cerebellum and the dorsolateral portion of the rostral medulla Occlusion: lateral medullary syndrome

medullary arteries
along with posteroinferior cerebellar artery, supply most of the medulla

 at lower border of pons, vertebral arteries unite to form the BASILAR ARTERY
ascends along the ventral midline of the pons and terminates near the rostral border of pons by dividing into 2 posterior cerebral arteries Vertebrobasilar arterial system
posterior circulation of brain

Branches:
branches to pons, cerebellum, internal ear
labyrinthine artery follows the course o the CN VIII and supplies inner ear anterior inferior cerebellar artery supplies part of the pons and the anterior and inferior regions of the cerebellum superior cerebellar artery supplies part of the rostral pons and superior region of the cerebellum pontine branches supply most of pons

 Posterior cerebral ateries

formed by the terminal bifurcation of the basilar artery anastomoses with the posterior communicating artery in the CoW Supply: lateral surface of the hemisphere occipital pole and inferior temporal lobe medial surface of the hemisphere occipital lobe and posterior 2/3 of temporal lobe

CIRCLE OF WILLIS
located at base of brain anterior part lies in front of optic chiasm posterior part situated just below the mamillary bodies allows for excellent collateral circulation
occlusion of an individual artery
often completely compensated by collateral circulation through the CoW

Formed by:
terminal part of the ICA proximal parts of the anterior, middle and posterior cerebral arteries anterior and posterior communicating arteries

1 Vertebral artery 2 AICA 3 Basilar artery 4 Superior cerebellar artery 5 Posterior cerebral artery 6 Posterior communicating artery 7 Middle cerebral artery 8 ICA 9 Opthalmic artery 10 Anterior cerebral artery 11 Anterior communicating artery 12 Hypothalamic artery 13 Anterior choroidal artery

VENOUS DRAINAGE OF BRAIN

veins of the brain have no muscular tissue in the wall and no valves Veins Located in the SAS Venous sinuses located between 2 layes of the dura superficial and deep veins of the brain drain into the dural venous sinuses (which in turn drain into the internal jugular veins) Superficial veins
drain the cortex and the more superficial hemispheric white mater mainly into the superior sagittal and cavernous sinuses

Deep or internal veins

drain the deep hemispheric white mater and basal ganglia into the 2 internal cerebral veins w/c unite to form the great cerebral vein

Great cerebral vein

formed by the union of 2 internal cerebral veins and drains into the straight sinus