Lecture 12 - Cerebral Blood Supply Flashcards Preview

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Flashcards in Lecture 12 - Cerebral Blood Supply Deck (14)
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1
Q

Circle of Willis

A

Made by Ant. cerebral artery, Middle cerebral artery (internal carotid artery), Post. comm. artery, and Post. cerebral artery, which joins together to form basilar artery
-PCA just anterior to CN3

2
Q

Middle Cerebral Artery

A
  • blood supply to most of the cerebral hemisphere
  • lateral frontal, parietal, temporal lobes
  • most of BG
  • most of deep white matter (usually including internal capsule)
3
Q

Anterior Cerebral Artery

A
  • medial frontal and parietal lobes

- wraps around corpus callosum

4
Q

Posterior Cerebral Artery

A
  • medial temporal and occipital lobes

- most or all of thalamus

5
Q

Variable arterial supply

A

deep branches of the ACA, MCA or PCA

-posterior limb of the internal capsule and lateral thalamus

6
Q

Border zone

A

AKA watershed zone

  • meeting between MCA and other (ACA or PCA) supply territory
  • anastomosis
7
Q

Cerebral arterial imaging

A
Ultrasound - carotid duplex (fast, safe, variable resolution)
Magnetic resonance angiogram
-slow, safe, good resolution
-magnet contraindications
Computed tomographic angiogram (CTA
-fast, better resolution
-iodinated contrast and radiation
Catheter angiogram
-best resolution
-iodinated contrast, radiation, catheter risks
8
Q

Cerebral venous sinuses

A

between dural layers

9
Q

Syndrome: Retinal artery

A

internal carotid –> ophthalmic –> retinal

  • common
  • complete (or entire retina) or branch (infarct)
  • monocular visual loss
  • altitudinal (shade coming down)
  • transient (amaurosis fugax)
  • **vision flipped
    • -> superior infarct = lower vision field affected
10
Q

Syndrome: Left MCA

A

-common
lateral frontal (face & arm) affected
-motor cortex (hemiparesis, dysarthria, dysphagia, apraxia)
-frontal eye field (gaze preference/paresis)
> eyes rest IPSI, paresis is CONTRA
-broca’s area (Broca’s aphasia)
-prefrontal cortex (decreased motivation, attention, exec fx)

lateral parietal (face & arm)

  • somatosensory cortex (hemisomatosensory loss, apraxia)
  • optic radiation (quadrantanopsia - inf. vision, CONTRA loss)

Lateral temporal

  • Wernicke’s area (Wernicke’s aphasia)
  • Optic Radiation

Deep white matter
-Long tracts (hemiparesis, hemisomatosensory loss)

11
Q

Syndrome: Right MCA

A

lateral frontal same as left MCA, except not aphasia (language is mostly on left side)

Lateral parietal
-add association cortex (hemineglect, anosognosia) to left MCA

Lateral temporal = optic radiation, no Wernicke’s

12
Q

Syndrome: ACA

A

UNCOMMON
Medial frontal
-motor cortex (leg weakness, apraxia)
-prefrontal/cingulate cotex (decreased motivation, attention and exec fx)

Medial parietal
-somatosensory cortex (leg somatosensory loss)

13
Q

Syndrome: PCA

A

common
Medial occipital
-visual cortex (hemianopsia with macular sparing)
>macula is more central and superficial, so there is enough collateral flow from MCA to keep macula alive

Medial temporal - usually nothing obvious

Thalamus - somatosensory loss

14
Q

Syndrome: Lacunes

A

small subcortical cerebral arteries
common
internal capsule = subcortical weakness
thalamus = subcortical somatosensory loss
lacunes are left as arteries deteriorate and are often asymptomatic