BLOOD SUPPLY OF

THE BRAIN
BY
Dr. Dalia M. Biram
ASSIST.Professor of Anatomy and
Embryology
❖ The brain is supplied by two pairs of arterial trunks:
A. The internal carotid arteries.
B. The vertebral arteries.
 Internal carotid artery
• This artery is divided into four segments: cervical, intrapetrosal,
intracavernous, and cerebral (supraclinoid) portions.
• The cerebral segment begins as the artery emerges from the
cavernous sinus and passes medial to the anterior clinoid
process. This portion of the artery, extending upwards and
backwards, gives rise to all major branches of the internal carotid
artery. These branches are:
1. The ophthalamic artery.
2. The posterior communicating artery.
3. The anterior choroidal artery.
Then the internal carotid artery divides lateral to the optic
chiasma into two terminal branches:
4. Anterior cerebral artery.
5. Middle cerebral artery: the larger of the two terminal branches,
and is regarded as the direct continuation of the internal carotid
artery.
 Vertebral artery
• The vertebral artery arises from the
first part of the subclavian artery. Its
course is divided into four parts. The
fourth part enters the cranial cavity
through the foramen magnum. This
part courses along the anterolateral
surface of the medulla and unites with
its fellow of the opposite side at the
lower border of the pons to form the
basilar artery.
❑ The intracranial part of vertebral artery
gives the following branches:
1. Anterior spinal artery:.
2. Posterior spinal artery:
3. Posterior inferior cerebellar artery.
4. Bulbar or medullary branches.
5. Posterior meningeal artery.
 Basilar artery
• The basilar artery passes along
the basilar groove on the
anterior surface of the pons and
it terminates at the upper
border of the pons by dividing
into two terminal branches
which are the posterior cerebral
arteries.
❑ The branches of the basilar
artery are:
1. The anterior inferior cerebellar
arteries.
2.The labyrinthine arteries
(supply the inner ear).
3. Numerous pontine branches.
4. The superior cerebellar
arteries.
5. The posterior cerebral arteries.
 Circulus arteriosus (circle of Willis):
• The cerebral arterial circle (of Willis)
is formed at the base of the brain by
the interconnecting vertebrobasilar
and internal carotid systems of
vessels. This anastomotic
interconnection is accomplished by:
• An anterior communicating artery
connecting the left and right anterior
cerebral arteries to each other.
• Two posterior communicating
arteries, one on each side,
connecting the internal carotid artery
with the posterior cerebral artery.
• The primary purpose of this vascular
circle is to provide anastomotic
channels if one vessel occluded.
 Anterior cerebral artery
• This artery is the smaller of the
two terminal branches of the
internal carotid artery. It
approaches the corresponding
artery of the opposite side with
which it connects via the anterior
communicating artery. The artery
enters the interhemispheric
fissure, passes upwards on the
medial surface of the hemisphere,
and continues posteriorly on the
superior surface of the corpus
callosum (callosal sulcus).
• Its cortical branches are
distributed mainly on the medial
surface of the cerebral
hemisphere.
 Middle cerebral artery
• It is the continuation of the
internal carotid artery beyond
the origin of the anterior
cerebral artery. It passes
laterally over the anterior
perforated substance to enter
the stem, then the posterior
ramus of the lateral sulcus.
• The artery divides into a
number of large branches
which emerge from the lateral
sulcus to be distributed in a
"fan-like" fashion over the
lateral convexity of the
hemisphere.
• Its cortical branches supply
most of the superolateral
surface
 Posterior cerebral artery
• The posterior cerebral arteries,
formed by the bifurcation of the
basilar artery, pass laterally
around the crus cerebri.
• After receiving anastomosis
from the posterior
communicating artery, the
posterior cerebral artery
continue along the lateral
aspect of the midbrain, and
then passes above the
tentorium to course on the
medial and inferior surfaces of
the temporal and occipital
lobes.
• Its cortical branches are
distributed mainly on the
tentorial surface and occipital
lobe of the cerebral
hemisphere.
• Occlusion of the posterior
cerebral artery produces a
contralateral homonymous
hemianopia; macular vision
is often spared due to
anastomosis between
branches of the middle and
posterior cerebral arteries
near the occipital pole.
 Blood supply of the medulla
❑To summarize the blood supply of the medulla:
A. Posterior region: Posterior spinal artery
B. Lateral region:
1. Upper part: Posterior inferior cerebellar artery
2. Lower part: Vertebral artery (bulbar branches)
C. Anterior region:
1. Upper part: Vertebral artery (bulbar branches)
2. Lower part: Anterior spinal artery
 Blood supply of the pons
❑ The ventral part of pons is supplied by
❑pontine branches of basilar artery. These
branches are.
❑ The dorsal part of the pons is supplied by
pontine branches of basilar artery
❑ anterior inferior cerebellar
❑the superior cerebellar arteries.
 Blood supply of the midbrain
• The main arterial supply of the midbrain is derived from
branches of the basilar artery. In addition, the midbrain
is also supplied by branches of the posterior cereberal
artery, the superior cerebellar artery, the posterior
communicating artery, and the anterior choroidal artery.
 Blood supply of the cerebellum
A. Arterial supply:
1. Superior cerebellar artery: It arises from the basilar artery,
curves round the brain stem, and passes onto the superior
surface of the cerebellum.
2. Anterior inferior cerebellar artery: It also arises from the
basilar artery. This artery supplies the pyramid, tuber,
flocculus and parts of the inferior surface of the cerebellar
hemisphere.
3. Posterior inferior cerebellar artery: It arises from the
vertebral artery. It courses laterally along the medulla where
small perforating rami supply the dorsolateral region of the
medulla. This artery then supplies the inferior vermis (nodule
and uvula), the inferolateral surface of the cerebellar
hemisphere.
 Venous Drainage of the Brain
A. Superficial cerebral veins: These veins drain the cortex and subcortical
white matter, anastomose freely in the pia, and form larger veins which empty
into the dural sinuses. These veins include:
1. Superior cerebral veins: they collect blood from the upper parts of the
superolateral and medial surfaces of the cerebral hemisphere. They drain into
the superior sagittal sinus.
2. Inferior cerebral veins: they collect blood from the inferior surface and lower
part of the lateral surface of the cerebral hemisphere. These veins drain into
the cavernous, sphenoparietal, petrosal and transverse sinuses.
3. The superficial middle cerebral vein, it courses along the posterior ramus of
lateral sulcus where it receives smaller veins on the lateral surface of the
hemisphere. It drains into the cavernous sinus.
B. Deep veins: These include
2 basal veins
2 internal cerebral veins which unite
together to form the great cerebral vein.
➢ Each basal vein receives:
1. Anterior cerebral vein.
2. Deep middle cerebral vein.
3. Inferior striate vein.
➢ Each internal cerebral vein
receives:
1. Thalamostriate vein.
2. Choroidal vein.
3. Septal vein.
4. Epithalamic vein.
5. Lateral ventricular vein.
➢ The great cerebral vein unites with
the inferior sagittal vein to form the
straight sinus.
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