Blood Supply

Brain

Introduction
One of the most metabolically active systems Normal cerebral blood flow is about 50 mL/100 g of brain tissue/min

Thus, a brain of average weight (1400 - 1500 g) has a normal blood flow of 700 - 750 mL/min

A blood flow of 25 mL/100 g of brain tissue/min constitutes ischemic penumbra (a dangerously deficient blood supply leading to loss of brain cells) A blood flow of 8 mL/100 g of brain tissue/min leads to an almost complete loss of functional neurons Consciousness is lost within 10 seconds of the cessation of blood supply to the brain

Arterial Supply of the Brain

Derived

from two arteries: (1) the internal carotid artery and (2) the vertebral artery These arteries and their branches arise in pairs that supply blood to both sides of the brain Basilar artery
Is a single artery But its braches are always in pairs
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Internal Carotid Artery - Branches

Ophthalmic artery Posterior communicating artery

Also supplies blood to the hypophysis, infundibulum, parts of the hypothalamus, thalamus, and hippocampus

Choroidal artery
Choroidal plexus of lateral ventircle Also supplies crus cerebri, lateral geniculate body, optic tract, & internal capsule

Anterior cerebral artery Middle cerebral artery

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Vertebro-Basilar Circulation
System

includes the two vertebral arteries, the basilar artery (which is formed by the union of the two vertebral arteries), and their branches the medulla, pons, mesencephalon, and cerebellum

Supplies

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Vertebral artery - Branches

Meningeal Posterior

branches

Bone & dura in posterior cranial fossa

spinal artery Anterior spinal artery

Contributing branches from each vertebral A.
Posterior

inferior cerebellar artery

Choroidal plexus of 4th ventricle, vermis, central nucleus, & undersuface of cerebellum, & medulla oblongata
Medullary

arteries
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Anterior Spinal Artery

Formed

by union of two small arising from each vertebral artery Supplies the medial structures of the medulla, which include the pyramids, medial lemniscus, medial longitudinal fasciculus, hypoglossal nucleus, and the inferior olivary nucleus Also Anterior 2/3rd of Spinal cord
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Posterior Inferior Cerebellar Artery (PICA)

Supplies the regions of the lateral medulla that include the spinothalamic tract, dorsal and ventral spinocerebellar tracts, descending sympathetic tract, descending tract of cranial nerve V, and nucleus ambiguus Also supplies the vermal region and inferior-lateral surface of the cerebellar hemisphere Wallenberg's syndrome Damage to the lateral medulla esp. N. ambiguss Presents as lack of coordination in speech (dysphonia), disturbance in articulation (dysarthria), and dysphagia (difficulty in swallowing)
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Posterior Spinal Artery (PSA)

Majority

of cases it arises from PICA Supplies the fasciculus gracilis and cuneatus as well as the gracile and cuneate nuclei, spinal trigeminal nucleus, dorsal and caudal portions of the inferior cerebellar peduncle, and portions of the solitary tract and dorsal motor nucleus of the vagus nerve

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Basilar artery - Branches

Pontine

arteries Labyrinthine artery Anterior inferior cerebellar artery Superior cerebellar artery Posterior cerebral arteries

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Pontine Arteries
Several pairs of pontine arteries arise from the basilar artery Paramedian arteries

Supply the medial portion of the lower and upper pons

Include pontine nuclei, corticopontine fibers, the corticospinal and corticobulbar tracts, and portions of the ventral pontine tegmentum, and medial lemniscus

Short circumferential arteries

Supply substantia nigra and lateral portions of the midbrain tegmentum
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Labyrinthine (Internal Auditory) Artery

Supplies

the cochlea and labyrinth

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Anterior Inferior Cerebellar Artery (AICA)

Supplies

the ventral and inferior surface of the cerebellum and lateral parts of the pons

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Superior Cerebellar Artery

Supplies

the rostral level of the pons, caudal part of the midbrain, and superior surface of the cerebellum
Includes portions of the superior and middle cerebellar peduncles, the medial and lateral lemniscus, part of the spinal trigeminal nucleus and tract, the spinothalamic tract, and superior cerebellar peduncle

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Circulation at the base of the brain

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Major Cerebral Blood Vessels

1. Anterior

cerebral artery 2. Middle cerebral artery 3. Posterior cerebral artery

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Anterior cerebral artery

Anterior communicating artery

Also supplies anterior hypothalamus, including preoptic and suprachiasmatic areas

Cortical branches
Oribtal branches Orbital & Medial surface of Frontal lobe Frontopolar branches - Medial portions of the frontal lobe and lateral parts of the convexity of the hemisphere Callosomarginal artery - Paracentral lobule and portions of the cingulate gyrus Pericallosal artery - Precuneus

Central branches
Medial striate artery (Recurrent artery of Heubner) Supplies anteromedial part of the head of the caudate nucleus and parts of the internal capsule, putamen, and septal nuclei
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Middle Cerebral Artery

Cortical

branches Central branches Lenticulostriate arteries Lateral striate branches

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Middle Cerebral Artery Branches

The lenticulostriate branches

Supply the putamen, caudate nucleus, and anterior limb of the internal capsule

Orbitofrontal artery
Parts of the frontal lobe

Precentral (pre-Rolandic) and central (Rolandic) branches

Supply different regions of the frontal lobe

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Middle Cerebral Artery Branches

Anterior Angular

and posterior parietal arteries

Supply different regions of the parietal lobe

branch posterior temporal

Supplies angular gyrus

Anterior, middle, and

arteries
Different regions of temporal lobe Branches of the posterior temporal artery also supply the lateral portions of the occipital lobe
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Posterior Cerebral Artery

Cortical

branches Central branches

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Posterior Cerebral Arteries

Supply

most of the midbrain, thalamus, and subthalamic nucleus and posterior temporal and parieto-occipital branches
Supply the temporal lobes and medial and inferior occipital lobes of the cerebral cortex

Anterior

Calcarine

artery
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Supplies the primary visual cortex

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Arteries of Specific brain areas

Corpus

striatum & Internal capsule Thalamus Midbrain Pons Medulla Oblongata Cerebellum

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Veins of Brain
External Cerebral Veins Superior cerebral veins Superficial middle cerebral veins Deep middle cerebral veins Inferior cerebral veins Anterior cerebral veins Striate veins Basal vein Internal Cerebral Veins Thalamostriate veins Choroid veins Great Cerebral vein

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