Vascular anatomy and arterial areas Flashcards
What is the recurrent artery of Heubner?
The longest branch from proximal ACA (the only one seen routinely on angiogram). ACA medial striate artery
Where does Heubner usually go off?
In the junction between ACA and A.Com a (90% from proximal A2)
On an axial plane, what artery supplies the middle frontal region?
ACA
On an axial plane, what artery supplies the middle posterior region incl Thalamus?
PCA (PCom and basilar also supplies thalamus)
What artery supplies most of the posterior limb and retrolentiform part of capsula interna?
The anterior choroidal artery (from distal ICA, between pCOm and the ICA bifurcation.)
What is the Recurrent artery of Heubner supplying
= The medial striate artery.
*The head of the caudate nucleus
* Medial globus Pallidus
* Anterior limb of the internal capsule.
* Anterior hypothalamus
* Nucleus accumbens
w more
part of hippocampi
What is the major vessel supplying hippocampus?
P2
What is the pericallosal artery?
The distal continuation of ACA. It extends from the exit of callosomarginal artery along sulcus of corpus callosum to the splenium
HOw many sehments does ACA have?
2 or 3 dependent on author.
Where does the A2 branch bifurcate?
At the pericallosal artery and callosomarginal artery
WHat is Heubners artery?
Its origin is near the A1-ACom-A2 junction of the ACA, arising from the proximal A2 in 90% of cases, and from the distal A1 in 10% of cases. Supplies the anteromedial part of the head of the caudate and anterior inferior internal capsule.
WHat does the MCA supply?
The cortical branches of the MCA supply the lateral surface of the hemisphere, except for the medial part of the frontal and the parietal lobe, which is supplied by the ACA, and the inferior part of the temporal lobe, which is supplied by the PCA.
What other important artery extend fro PCA?
pCOmA
What does Posterior thalamoperforating arteries branching off the P1 segment of PCA do?
Supply blood to the midbrain and thalamus
WHat important structures does the cortical branches of PCA supply?
The inferomedial part of the temporal lobe, occipital pole, visual cortex, and splenium of the corpus callosum. In addition, the arterial supply of hippocampus usually arises from PCA.
Where are the two major watershed areas located?
*Cortical border zone infarctions
Infarctions of the cortex and adjacent subcortical white matter located at the border zone of ACA/MCA and MCA/PCA
*Internal border zone infarctions
Infarctions of the deep white matter of the centrum semiovale and corona radiata at the border zone between lenticulostriate perforators and the deep penetrating cortical branches of the MCA or at the border zone of deep white matter branches of the MCA and the ACA
The corpus callosum has a rich blood supply, relatively constant and is uncommonly involved by infarcts. The majority of the corpus callosum (CC) is supplied by the pericallosal arteries. Where do they come from?
Branches from the anterior and posterior cerebral respectively.
(In 80% of patients additional supply comes from the anterior communicating artery, via either subcallosal artery or median callosal artery.)
The basal ganglia are supplied by perforating branches of the anterior cerebral artery and middle cerebral artery. What are they called?
Medial lenticulostriate arteries, from the ACA, supply the globus pallidus and medial portion of the putamen.
Lateral lenticulostriate arteries, from the MCA, supply the lateral portion of the putamen.
Recurrent artery of Heubner, arising as a large branch from the ACA supplies the caudate nucleus.
How is the Midbrain supplied?
Small penetrating branches from:
basilar artery
superior cerebellar artery
posterior cerebral artery
How is the Pons supplied?
medial branches of the superior cerebellar artery
pontine branches of basilar artery, thalamoperforator arteries
How is the medulla supplied?
posterior inferior cerebellar artery (PICA)
anterior spinal artery
direct branches of the distal vertebral artery
What does PICA supply?
Has a variable territory depending on the size of the AICA, but usually supplies:
posteroinferior cerebellar hemispheres (up to the great horizontal fissure)
inferior portion of the vermis
18% arise extracranially, inferior to the foramen magnum
10% arise from the basilar rather than vertebral artery
2% bilaterally absent
occasionally loops around the cerebellar tonsil
WHat does SCA supply?
This vessel supplies:
whole superior surface of the cerebellar hemispheres down to the great horizontal fissure
the superior vermis
dentate nucleus
most of the cerebellar white matter
Där man ser hörselgångarna på en axial, med en cerebellär infarkt, vilket kärl har trombotiserat?
PICA
What does the artery of Percheron supply?
What is cerebral hyperperfusion syndrome?
A rare complication seen after treatment of long-standing severe carotid stenosis by carotid endarterectomy or carotid artery stenting. It is believed to be the result of a failure of normal cerebral blood flow autoregulation.
WHat is this?
The presence of a crescent sign on fat-saturated T1 imaging surrounding the left carotid artery is consistent with a carotid dissection.
Explain the major cerebral vascular territories
What are the two artery territories seen?
Green=basilar
Purple=PICA
Explain the arterial areas of posterior fossa-pontic level.
Explain the vascular territories in the level of the eyebulb, just before the basilar apex
What is “artery of Percheron”?
Its a variant of the posterior cerebral circulation characterized by a solitary arterial trunk that supplies blood to the paramedian thalami and the rostral midbrain bilaterally.
Lateral medullary syndrome, also known as Wallenberg syndrome, is a clinical syndrome caused by an acute ischemic infarct of the lateral medulla oblongata.
What areries might be causing it?
PICA or VA
Expected symtoms from this ischemia?
Lower motor neuron facial nerve palsy including loss of sensation of the taste in anterior two-thirds of the tongue and hyperacusis, diplopia and horizontal conjugate gaze palsy.
(This is infarct involves the facial colliculus which is formed by the fibers of the facial nerve passing behind the abducens cranial nerve nucleus before heading anterolaterally towards its exit at the pontomedullary junction. The medial longitudinal fasciculus (MLF) is located near the midline and may be involved. )
WHat is a fetal type posterior artery?
Variant of cerebrovascular anatomy in which the distal posterior cerebral artery (PCA) territory is practically a part of the anterior circulation.
how common is fetal type PCA?
estimated to occur in 20-30% of individuals
WHat happen if fetal PCAs are seen bilaterally?
The basilar artery is significantly smaller than normal.
what artery arises between the internal carotid artery between the posterior communicating artery and the ICA bifurcation
the anterior choroidal artery.
What is an azygous anterior cerebral artery?
Rare and characterized by a single vessel which provides the blood supply to both anterior cerebral hemispheres.
