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THE

CEREBROVASCULAR
SYSTEM
CEREBROVASCULAR
SYSTEM
• Brain makes up only of about 2% of
total body weight in adults
• It receives 15% - 17% of the total
cardiac output
• It consumes about 20% of the oxygen
used by the entire body (3.5 ml/100
gm/min)
• Cerebral blood flow at rest is 50-55
ml/100 gm /min)
CEREBROVASCULAR
SYSTEM
• PaO2 < 45 mm Hg – difficulty with complex task
learning & short term memory
• PaO2 = 30 mm Hg – cognitive disturbance &
incoordination
• PaO2 < 20 mm Hg – comatous
• Loss of consciousness if brain deprived of blood
for 10=12 seconds; after 3-5 min. irreparable
damage or death may result
CIRCLE OF WILLIS PERFORATING
BRANCHES
INTERNAL CAROTID
ARTERY

- Cerebral part –
where it
penetrates the dura
coming out from the
cavernous sinus;
ophthalmic,
posterior
communicating,
anterior
choroidal arteries,
MCA,
ACA
- Cavernous part –
passes
thru the cavernous
sinus;
gives rise to
hypophysial
& meningeal
A5 segment Callosal cistern

A4 segment

A3 segment

A2 segment

A1 segment (not seen


Lamina terminalis
ANTERIOR CEREBRAL ARTERY (ACA) cistern

- 5 segments: precommunicating A1, infracallosal A2,


precallosal A3,
supracallosal A4, & postcallosal A5
- serves the LE area of the primary somatomotor &
somatosensory
cortices
- 30% - 35% of all intracranial artery aneurysms are found in
the
MCA:
- M2-M4 divides into superior and inferior trunks that supplies
the
insular cortex, inner aspects of opercula, & lateral surface of
the
cerebral hemisphere
- serves the face, UE, & trunk areas of the primary
somatomotor &
somatosensory cortices
BASILAR ARTERY
- located in the basilar
sulcus on the
anterior
surface of the pons in

prepontine cistern
- 1st major br. AICA ( br
of
AICA is labyrynthine
artery)
- pontine arteries:
paramedian br.,
short
circumferential br.,
long
circumferential br
- last major br. –
superior
cerebellar arteries
which
divides into medial &
lateral br
POSTERIOR CEREBRAL ARTERY
- Basilar artery bifurcates in the interpeduncular cistern giving
rise to
posterior cerebral arteries
- divided into 4 segments P1 – P4; supply along the
occipitotemporal
distribution, to regions of the brain controlling visual input and
higher
level visual processing
External Cerebral Veins:
- Superior cerebral veins SSS
- Middle cerebral veins CavS,
SSS, TS
- Medial cerebral veins ISS
- Inferior cerebral veins SSS,
SPetS
- Basal veins of Rosenthal
CVGalen, TS
Internal Cerebral Veins:
- Thalamostriate vein ICV
- Anterior septal vein ICV
- Internal cerebral veins (ICV)
CVGalen
Cerebellar Veins:
- Superior (Galenic) group StS,
TS, PetS
Main tributaries of
- Aneurysm of the Cavernous Sinus
cavernous - intercavernous sinuses
portion of ICA - drains into the superior &
- Carotico-Cavernous Fistula inferior petrosal sinuses
and the basilar plexus
Deep veins
Ant. Cerebral & Deep

Middle veins

Basal vein of
Rosenthal

Internal Cerebral Vein

Vein of Galen

Straight Sinus

Confluence of sinus

Transverse sinus

Sigmoid sinus
*Cerebral Venous Thrombosis
Int. Jugular
-severe vein
dehydration
-birth control pills
-hypercoagulable condition
ARTERIES OF THE SPINAL
CORD

- Anterior Spinal artery


- Posterior Spinal arteries
- Spinal branches of
segmental (sulcal) arteries:
- posterior (dorsal)
- anterior (ventral) radicular
a.
and spinal medullary
arteries
all contribute to the arterial
vasocorona
- At level T12, L1 or L2, one
spinal medullary artery,
usually
the left, is especially large
and
is known as Artery of
Adamkiewicz