21 Cerebrum Blood Supply Flashcards
Anterior circulation includes input from what artery and out put to what 4 arteries?
input from internal carotid and output to opthalmic artery (orbit), anterior choroidal artery (deep hemisphere) and anterior and middle cerebral arteries (cerebrum)
Posterior circulation includes input from what artery and output to what arteries?
input from the inferior cerebellar artery, fuse to form the basilar artery and then give off the anterior inferior and superior cerebellar arteries before dividing into posterior cerebral arteries
What arteries do the anterior and posterior communicating arteries connect?
anterior communicating arteries connect anterior cerebral arteries while posterior communicating arteries connect internal carotid and posterior cerebral arteries (via the circle of Willis)
Name the three bilateral pairs of cerebellar arteries and what they branch from.
Posterior inferior (vertebral artery) anterior inferior (inferior basilar artery) superior (superior basilar artery)
What areas does the middle cerebral artery serve?
lateral frontal, parietal and temporal lobes, most of the basal ganglia and most of the deep white matter (usually including the internal capsule)
What areas do the anterior cerebral artery serve?
medial frontal and parietal lobes
What areas do the posterior cerebral artery serve?
medial temporal and occipital lobes, most or all of the thalamus
What is special about the blood flow to the lateral thalamus and the posterior limb of the internal capsule?
it is highly variable and can include branches of the middle cerebral artery, posterior cerebral artery or anterior choroidal artery
What about particular small vessels in the brain makes them particular vulnerable to damage over a life time?
some blood vessels are branches off of fairly large vessels that see considerable pressure (higher pressure for a small vessel over a whole lifetime is dangerous)
Describe the type of visual symptoms that come with retinal artery syndrome
can include a common or end branch resulting in monocular visual loss that is sometimes altitudinal and/or transient
What deficits would be expected with a left middle cerebral artery syndrome? (common)
damage to lateral frontal lobe causing motor symptoms in face and arms, gaze preference/ paresis, Broca’s area aphasia and diminished motivation, attention and executive function; damage to the lateral parietal area resulting in somatosensory loss, apraxia and blindness in a given optic quadrant; damage to the lateral temporal area resulting in Wernicke’s aphasia and blindness in a given optic quadrant; and damage to deep white matter affecting long tracts and hemipareiss and hemisomatorsensory loss
What symptoms would you expect of a patient with right middle cerebral artery syndrome? (common)
** usually does not include language and can include hemineglect*** also: damage to lateral frontal cortex (motor cortex, frontal eye field and prefrontal cortex) damage to lateral parietal (somatosensory, association cortex and optic radiation) as well as damage to deep white mater
What distinct symptom would you expect of anterior cerebral artery syndrome?
will affect the leg, both motor and sensory with some affects to the medial frontal cortex leading to diminished motivation, attention and executive function
Describe the symptoms of posterior cerebral artery syndrome. (common)
hemianopsia with macular sparing (damage to the medial occipital) as well as somatosensory loss due to involvement with the involvement of the thalamus BONUS: macula is spared because innervation of the fovea is more posterior and not affected as much in some cases
What are lacunas?
small subcortical cerebral arteries (common) that are damaged because of infarct, can result in damage to the internal capsule and thalamus resulting in subcortical weakness and subcortical somatosensory loss
