Blood Supply and Venous Drainage

Question 1

Branches of vertebral artery

Answer 1

• anterior spinal
• posterior spinal
• posterior inferior cerebellar (PICA)

Question 2

Branches of basilar artery

Answer 2

• posterior cerebral
• superior cerebellar
• anterior inferior cerebellar (AICA)
• pontine
• labyrinthine

Question 3

Supply to cerebellum

Answer 3

• superior cerebellar
• anterior inferior cerebellar
• posterior inferior cerebellar

Question 4

Supply to medulla

Answer 4

• anterior spinal (medial)
• vertebral
• PICA (lateral of rostral)
• posterior spinal (lateral of caudal)

Question 5

Supply to pons

Answer 5

• pontine arteries (paramedian supply medial, circumferential supply lateral)
• superior cerebellar (dorsal of rostral)
• AICA (dorsal of caudal)

Question 6

Supply to midbrain

Answer 6

• posterior cerebral artery, collicular branch (dorsal)
• posterolateral perforating arteries (lateral)
• posteromedial perforating arteries (medial)

Question 7

Posterior cerebral artery

Answer 7

Supplies:
- midbrain
-occipital lobe
- inferior/medial temporal lobe

Question 8

Anterior supply

Answer 8

Branches of internal carotid artery:
- anterior choroidal
- anterior cerebral
- middle cerebral
- posterior communicating
- opthalmic

Question 9

Anterior cerebral artery

Answer 9

Supplies medial surface of hemispheres:
- pericallosal (supply parietal)
- callosomarginal (supply frontal)

Question 10

Middle cerebral artery

Answer 10

Supplies the lateral surface of the hemispheres, including:
- M1, S1 and A1
- Broca’s and Wernicke’s areas
- auditory and POT association areas

Question 11

Anterior choroidal artery

Answer 11

• choroid plexus
• hippocampus and amygdala
• optic tract
• posterior limb of internal capsule
• globus pallidus

Question 12

Perforating arteries

Answer 12

• anteromedial (anterior hypothalamus, septal area)
• anterolateral (striatum, globus pallidus, anterior/posterior limb of internal capsule)
• posteromedial (medial midbrain, thalamus, posterior hypothalamus)
• posterolateral (lateral midbrain, posterior thalamus)

Question 13

Medial striate artery

Answer 13

Supplies:
- head of caudate
-anterior limb of external capsule

Question 14

Dural folds

Answer 14

• falx cerebri
• tentorium cerebellum
• diaphragma sellae

Question 15

Dural sinuses

Answer 15

• superior sagittal (falx)
• inferior sagittal (falx)
• straight (between flax and tentorium)
• transverse (tentorium)
• confluence of sinuses
• cavernous
• sigmoid
• superior petrosal
• inferior petrosal

Question 16

Superficial veins

Answer 16

Blood from lateral hemisphere drains into superior sagittal sinus.
Blood from medial hemisphere drains into inferior sagittal sinus -> straight sinus.
Both end up in confluence of sinuses -> transverse -> sigmoid -> internal jugular vein

Question 16

Deep veins

Answer 16

Blood drains from deep structures (thalamus, basal ganglia, etc.) into great cerebral vein. This drains into straight sinus -> confluence of sinuses -> transverse -> sigmoid -> internal jugular.

Question 17

Cavernous sinus

Answer 17

Drains into superior petrosal sinus -> sigmoid -> internal jugular vein.
OR drain into inferior petrosal sinus -> jugular vein.

Question 18

Types of haemorrhage

Answer 18

• epidural (haematoma between skull and dura, rupture of meningeal artery, clean lens shape)
• subdural (haematoma beneath dura, rupture of superficial vein)
• intracerebral (rupture of intracerebral vessel (eg. berry aneurysm)

Question 19

Choroid plexus locations

Answer 19

• lateral ventricle: inferior horn, collateral trigone and body
• 3rd ventricle: roof
• 4th ventricle: inferior medullary velum

Question 20

CSF production

Answer 20

CSF is made from filtered plasma. It has less cells, proteins, glucose, K and Ca ions. It has more Mg and Cl ions.

Question 21

CSF reabsorption

Answer 21

CSF reabsorbed through arachnoid granulations in superior sagittal sinus. This is via passive transport.

Question 22

Hydrocephalus

Answer 22

Occurs when CSF production > absorption.
- non-communicating (flow of CSF blocked within ventricles (eg. tumour compressing aqueduct)
- communicating (reduced CSF reabsorption (eg. due to haemorrhage in superior sag. sinus) or due to excess CSF production due to tumour of choroid plexus)