Blood Supply of Central Nervous System PDF

Blood supply of central nevous system Vascular supply to CNS SPINAL CORD Anterior spinal artery - Anterior midline - Supplies the anterior 2/3 of the cord Posterior spinal arteries son dos - On either side of midline but medial to dorsal roots - Supply the posterior 1/3 of the cord A...

Blood supply of central nevous system Vascular supply to CNS SPINAL CORD Anterior spinal artery - Anterior midline - Supplies the anterior 2/3 of the cord Posterior spinal arteries son dos - On either side of midline but medial to dorsal roots - Supply the posterior 1/3 of the cord Arterial supply to CNS BRAIN Internal carotid arteries ICA hay dos - Supply the anterior, superior and lateral cerebral hemispheres - Pertenece al carotid canal of temporal bone - Al entrar al cranial cavity - \- ventral to CN II nervio optico Vertebral arteries hay dos - Supply brainstem, cerebellum and posteriorinferior cerebrum Common carotid artery CCA ICA branches +-----------------------+-----------------------+-----------------------+ | Ophthalmic artery | Central artery of | A diagram of the | | | retina | human body | | Primera rama que sale | | Description | | de la ICA | Cranial dura | automatically | | | | generated | +=======================+=======================+=======================+ | Anterior cerebral | Medial aspect of | | | artery | hemisphere | | | | | | | | Pre and post central | | | | gyrus | | +-----------------------+-----------------------+-----------------------+ | Anterior | Anterior hypothalamus | | | communicating artery | (preoptic and | | | | surprachiasmatic | | | | areas) | | | | | | | | common site site for | | | | aneurysms | | +-----------------------+-----------------------+-----------------------+ | Recurrent artery of | Anteromedial part of: | | | heubner | | | | | Caudate nucleus | | | (medial striate | | | | artery) | Internal capsule | | | | | | | | Putamen | | | | | | | | Septal nuclei | | +-----------------------+-----------------------+-----------------------+ | Anterior choroidal | Lateral ventricle | | | artery | choroid plexus | | | | | | | | Optic tract | | | | | | | | Internal capsule | | | | | | | | Hippocampal formation | | | | | | | | Globus pallidus | | | | | | | | Thalamus | | +-----------------------+-----------------------+-----------------------+ | Posterior | Hypophysis | | | communicating artery | | | | | Infundibulum | | | | | | | | Hypothalamus | | | | | | | | Thalamus | | | | | | | | Hippocampus | | +-----------------------+-----------------------+-----------------------+ Anterior cerebral artery ACA Branches Supple superior y medial +-----------------------+-----------------------+-----------------------+ | Orbital branches | Orbital surface |  | +=======================+=======================+=======================+ | Frontopolar artery | Frontal lobe pole | | +-----------------------+-----------------------+-----------------------+ | Callosomarginal | Paracentral lobule | | | artery | | | | | Cingulate gyrus | | +-----------------------+-----------------------+-----------------------+ | Pericallosal artery | Precuneus | | +-----------------------+-----------------------+-----------------------+ Middle cerebral artery branches MCA= highest incidence of ischemic stroke Suple la parte lateral de los hemisferios +-----------------------+-----------------------+-----------------------+ | Lenticulostriate | MCA 1^st^ branches | | | arteries | | | | | Putamen | | | | | | | | Caudate nucleus | | | | | | | | Ant. Limb of internal | | | | capsule | | +=======================+=======================+=======================+ | Orbitofrontal artery | Lobulo frontl | | | | asociada al area de | | | | la orbita | | +-----------------------+-----------------------+-----------------------+ | Central (Rolandic) | En el sulco central | | | artery | | | +-----------------------+-----------------------+-----------------------+ | Precentral | Supple parte lateral | | | (prerolandic) artery | media del lobulo | | | | frontal | | +-----------------------+-----------------------+-----------------------+ | Anterior parietal | Parte anterior lobulo | | | artery | parietal | | +-----------------------+-----------------------+-----------------------+ | Posterior parietal | En la parte lateral | | | artery | posterior del lobulo | | | | parietal | | +-----------------------+-----------------------+-----------------------+ | Angular artery | Giro angular | | +-----------------------+-----------------------+-----------------------+ | Anterior, Middle & | Parte lateral del | | | Posterior Temporal | lobulo temporal | | | Arteries | | | +-----------------------+-----------------------+-----------------------+ Vertebral artery branches Posterior inferior cerebellar artery PICA Lateral medulla, vermal region & Post. Inf. & lateral part of Cerebellum ------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Posterior spinal artery Nuclei/Fasciculus gracilis and cuneatus, spinal trigeminal nucleus, dorsal and caudal portions of the inferior cerebellar peduncle, and portions of the solitary tract and dorsal motor nucleus CN X Anterior spinal artery Pyramids, medial lemniscus, medial longitudinal fasciculus, hypoglossal nucleus, & inferior olivary nucleus PICA (Wallenberg's) Syndrome Ipsilateral Ataxia Dysphonia, Dysarthria & Dysphagia Vertigo & Nystagmus ⦿ Ipsilateral Horner's Syndrome ⦿ Pain & Temperature Loss from Ipsilateral face & Contralateral body Basilar branches Labyrythine (internal auditory) artery Cochlea & Labyrinth  -------------------------------------------- ------------------------------------------------------------------------ ----------------------- Anterioir inferioir cerebellar artery AICA Ventral-inferior cerebellum & lateral parts of the pons Pontine arteries Suple el pons Superior cerebellar artery Rostral pons, caudal midbrain & Superior cerebellum Posterior cerebral artery Midbrain, thalamus, and subthalamic nucleus, temporal & occipital lobe PCA branches +-----------------------+-----------------------+-----------------------+ | Ant. Temporal | | | | Branches | | | +=======================+=======================+=======================+ | Post. Temporal | | | | Branches | | | +-----------------------+-----------------------+-----------------------+ | Calcarine a. | Va al lobulo | | | | occipital | | | | | | | | Supple el lobulo | | | | calcarino | | +-----------------------+-----------------------+-----------------------+ Circle of willis **Importance:** Collateral circulation during reduction or blockage of blood flow Se compone de: **ICA (2)** **ACA (2)** **Ant. Comm. a.** **Post Comm. a. (2)** **PCA (2)** **Cerebral blood flow** NORMAL VALUE 700-750 ------------------- --------- Ischemic penumbra 350 Loss of neurons 120 +-----------------------------------+-----------------------------------+ | Arteries dilate | BP | | | | | | O2 | | | | | | PH | | | | | | INADEQUATE | +===================================+===================================+ | | CO2/ LACTIC ACID | | | | | | EXCESSIVE | +-----------------------------------+-----------------------------------+ | Arteries constrict | BP | | | | | | O2 | | | | | | PH | | | | | | EXCESSIVE | +-----------------------------------+-----------------------------------+ | | CO2/ LACTIC ACID | | | | | | Functional levels | +-----------------------------------+-----------------------------------+ **Consciousness is lost** within 10s of cessation of blood supply **Brain Damage** AFTER \~5 min of cessation of blood supply Watershed areas: Site of anastomoses among the distal branches of cerebral arteries that is *vulnerable to ischemia* *Venous drainage:* Senos venosos- venas metidas en el espacio dural Superior sagittal sinus confluence of sinus transverse sinus sigmoid sinus Internal jugular veins Inferior sagittal sinus straight sinus confluence of sinus transverse sinus sigmoid sinus Internal jugular veins Jugular subclavia brachiocephalic izq/der- vena cava superior Dural venous sinuses internal jugular veins subclavian veins brachiocephalic veins superior vena cava