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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 branches
- Petrous part – located in
the carotid canal; no
branches
- Cervical part – cervical
area
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
AComA – ACA complex; visual problem, motor weakness,
hydrocephalus
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
- aneurysms on the MCA usually arise at the bifurcation of M1 into the
superior & inferior trunks
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
- 10%-15% of all
intracranial aneurysms
occur in the basilar
bifurcation
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
- Anterior or petrosal group SPetS
- Posterior or tentorial group TS, StS
Main tributaries of Cavernous
- Aneurysm of the cavernous Sinus
portion of ICA - intercavernous sinuses
- Carotico-Cavernous Fistula - drains into the superior &
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

Int. Jugular vein


*Cerebral Venous Thrombosis
-severe 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

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