Blood supply to the brain

Question 1

Internal carotid artery

Answer 1

enters the circle of Willis and divides to form the anterior cerebral and middle cerebral arteries

Question 2

Anterior cerebral arteries

Answer 2

supplies the medial and superior strip of the lateral aspect of the cerebral cortex up to the parietal/occipital border

Question 3

Middle cerebral artery

Answer 3

• supplies most of the lateral aspect of the cerebral cortex

- includes Broca and Wernicke’s areas in dominant hemisphere

Question 4

Posterior cerebral artery

Answer 4

-arises from basilar artery and supplies the inferomedial temporal lobe and the occipital lobe

Question 5

Blood supply to the medulla

Answer 5

-posterior inferior cerebellar arteries and anterior spinal branches of the vertebral arteries

Question 6

Blood supply to Pons

Answer 6

-supplied by basilar artery that runs along the midline of the pons

Question 7

Carotid system TIA

Answer 7

• Amaurosis Fugax- blockade of retinal arteries
• Aphasia
• Hemiparesis
• Hemisensory loss
• Hemianopic visual loss

Question 8

Vertebrobasilar TIA

Answer 8

• diplopia, vertigo, vomiting
• choking and dysarthria
• ataxia
• alexia without agraphia
• hemisensory loss
• hemianopic visual loss
• transient global amnesia
• tetraparesis
• loss of consciousness (rare)

Question 9

Anterior cerebral artery

Answer 9

• supplies medial suface
• bilateral infract causes quadriparesis (legs weaker than arms) and akinetic mutism (ventromedial or cingulate syndrome)

Question 10

Recurrent artery of Huebner

Answer 10

• branch of the ACA
• supplies the head of caudate nucleus
• lesion causes agitation, confusion and evolves to akinesia, abulia (absence of willpower), with mutism and personality changes

Question 11

Anterior branches of the upper division of the middle cerebral artery

Answer 11

• supplies the lateral prefrontal cortex
• lesion causes planning deficits, impairment of working memory and apathy
• DLPFC dysfunction

Question 12

Anterior communicating artery

Answer 12

• supplies basal forebrain
• lesion causes akinesia and personality change (orbitofrontal dysfunction) with a confabulatory amnesia resembling Wernicke-Korsakoff’s syndrome

Question 13

Posterior inferior cerebellar artery (PICA) thrombosis

Answer 13

• supplies the lateral medulla
• Wallenberg’s lateral medullary syndrome
• acute vertigo with cerebellar signs
• Ipsilateral face numbness, diplopia, nystagmus, Horner’s syndrome and 9th/10th nerve palsy with contraalateral spinothalamic sensory loss and mild hemiparesis