Vascular Territories
In this chapter, the vascular territories of the brain as viewed in the axial planes on CT or MRI are presented.
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Vascular Territories
In this chapter, the vascular territories of the brain as viewed in the axial planes on CT or MRI are presented. The cerebral hemispheres are vascularized by the anterior cerebral (ACA), middle cerebral (MCA), posterior cerebral (PCA), and anterior choroidal (AchA) arteries. From the proximal segments of these arteries (A1, M1, P1) and cisternal segment of the choroidal artery, small branches (deep perforators) arise that enter the brain parenchyma at the level of the anterior and posterior perforated substance supplying basal ganglia, thalamus, and internal capsule. Other perforators arise from the anterior communicating (AComA) and posterior communicating (PComA) arteries, which belong to the circle of Willis, and from the distal segment of the internal carotid artery. The perforators are end-arteries with no possible collateral circulation. From the more distal branches of ACA, MCA, PCA, and AchA, cortical arteries that supply the cortex and arteries that enter the white matter (medullary
arteries) arise. Like the deep perforators, the medullary arteries are also end-arteries. On the contrary, there are potential pial (leptomeningeal) anastomoses among the cortical branches of all the main trunks (Fig. 8.1). In the posterior fossa, medulla and pons are vascularized by perforators arising from the vertebral basilar, and anterior and posterior spinal arteries. The midbrain is vascularized by perforators of PCA and AchA. Furthermore, perforating branches for medulla, pons, and midbrain arise from the first segments of the three cerebellar arteries (PICA, AICA, and SCA). All these perforators are end-arteries. Cerebellum is supplied by the three cerebellar arteries: the cortical branches supply the cortex and the medullary arteries supply the white cerebellar matter and deep nuclei. Medullary arteries are end-arteries, while potential pial anastomoses are present among the cortical branches (Fig. 8.2). More details about vascularization are presented in Chaps. 2, 4, 5, 6, and 7.
G.B. Bradac, Cerebral Angiography, DOI 10.1007/978-3-642-54404-0_8, © Springer-Verlag Berlin Heidelberg 2014
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Cortex, white matter and a few grey nuclei
Thalamus (Th)
Anterior Cerebral Artery (ACA) Middle Cerebral Artery (MCA) Posterior Cerebral Artery (PCA) Anterior Choroidal Artery (AChA) Anterior Thalamo-perforating Arteries Posterior Thalamo-perforating Arteries Thalamo Geniculate Arteries Posterior Medial–Lateral Choroidal Arteries
Putamen (P) Lateral Pallidum (PL) Medial Pallidum (PM)
Perforators of M1 Perforators of ACA (Heubner) Perforators of AChA
Nucleus Caudatus (CN)
Perforators of M1 Perforators of ACA (Heubner) Perforators of AChA
Internal Capsule (IC)
Perforators of M1 Perforators of ACA (Heubner) Perforators of AChA Perforators of Internal Carotid Artery
Fig. 8.1 Vascular territories of the cerebral hemispheres
Vascular Territories
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Vascular Territories
Medulla
Pons
ASA PSA BA VA PICA AICA SCA
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Perforators of VA and ASA Perforators of VA and PICA Perforators of PICA a
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