Blood Vessels

 

On this page:

 

Complaints and consequences classified per artery, in case of failure

Names of the arteries in Latin


Two carotid arteries and their branches (anatomy)

Circulatory area of three cerebral arteries


Two vertebral arteries and their branches (anatomy)

Circle of Willis (anatomy)


The veins of the brain (venous system)

Blood circulation in the skull and scalp (with downloads)


Blood vessels in the brain

There are two types of blood vessels: the arteries (also called arteries/arteria, abbreviated a.) and the veins (also called veins/vena, abbreviated v.).

 

A number of large blood vessels, arteries, run from the body artery (aorta) to the brain. Arteries transport oxygen and nutrients to the brain. The brain is supplied with blood through four arteries:

 

  • Two carotid arteries (carotid arteries) at the front of the neck. They supply 80% of the brain with blood and thus with oxygen and glucose.
  • Two vertebral arteries / vertebral arteries (arteria vertebralis) that run at the back of the neck along the vertebrae to the brain. They provide the remaining 20% of the blood flow. The vertebral arteries supply blood to the upper part of the spinal cord, the brain stem, the cerebellum and the posterior part of the brain.

 

The two vertebral arteries together form the basilar artery.

The arteries are colored red in the image below.

 

Naming

 

Name plus abbreviation Latin
Anterior cerebral artery (ACA) Arteria cerebri anterior
Middle cerebral artery (MCA / ACM) Arteria cerebri media
Posterior cerebral artery (ACP) Arteria cerebri posterior
Internal carotid artery (ICA) Arteria carotis interna
Common carotid artery (CCA) Arteria carotis communis
Basilar artery (BA) Arteria basilaris
Vertebral artery (VA) Arteria vertebralis
Posterior cerebral artery (PCA) Arteria cerebri posterior
Posterior communicating artery (PComm) Arteria communicans posterior
Anterior communicating artery (ACOM) Arteria communicans anterior

Blood supply to:

Cerebrum Anterior cerebral artery (ACA)
Middle cerebral artery (MCA / ACM)
Posterior Cerebral artery (ACP)
Brainstem Posterior cerebral artery (ACP)
Basilar artery (BA)
Vertebral artery (VA)
Superior celebellar artery (SCA)
Anterior inferior celebellar artery (AICA)
Posterior inferior celebellar artery (PICA)
Anterior spinal artery (ASA)
Cerebellum / Little brain Superior celebellar artery (SCA)
Anterior inferior celebellar artery (AICA)
Posterior inferior celebellar artery (PICA)
Spinal cord Anterior spinal artery (ASA)
Posterior spinal artery (ASP)

The two carotid arteries (arteriae carotis) and their branches

The common carotid artery (Arteria carotis communis arises from the aortic arch or a major branch of this arch (truncus brachiocephalis).

This carotid artery branches at the level of the angle of the jaw into:

  • Inner carotid artery / Arteria carotis interna,
  • Outer carotid artery / Arteria carotis externa

 

 

  • Arteria carotis externa; This external carotid artery provides blood flow to:
    • the thyroid gland
    • the larynx
    • the tongue
    • the face; the facial muscles

 

  • Arteria carotis interna; This internal carotid artery only branches at the base of the skull and makes an S-bend there, then gives a branch to the eye and then branches further into:
    • Arteria cerebri anterior (ACA) supplies both large cerebral hemispheres on the medial and dorsal sides of the body with blood from the
      1. frontal lobes and
      2. parietal lobes

The ACA supplies the entire medial part of the brain, i.e. the part for the inside of the body, with blood. the ACA is the least commonly affected by stroke and therefore injury to the ACA can easily be misdiagnosed.

 

The ACM supplies blood to the entire lateral side of the brain. Strokes in the ACM are very common. (Teasell, 1998)

 

 

  • Arteria communicans posterior

 

Circulatory area's ACA, ACM, ACP

Yellow: Arteria cerebri anterior

Red: Arteria cerebri media

Blue: Arteria cerebri posterior

 

 

The two vertebral arteries (arteriae vertebralis) and their branches: the vertebrobassilar system

 

 

  • The branches of the basilar artery are:
    • Arteria spinalis anterior (ASA) anterior spinal artery 
    • Arteria spinalis posterior (ASP) posterior spinal artery
    • Arteria cerebelli superior (SCA) 
    • Arteria cerebelli anterior inferior (AICA) anterior inferior cerebellar artery
    • Arteria cerebelli posterior inferior (PICA) posterior inferior cerebellar artery
    • Ramni meningi arteriae vertebralis

 

From here the basilar artery branches into the ACP (however, in 5-25% of people the ACP comes from the carotid artery).

 

The primary function of the occipital lobe is vision. A stroke in the ACP commonly causes visual deficits, especially contralateral homonymous hemianopia (visual loss).

 

  • Posterior communicans artery that connects the internal carotid artery with the artery in the circle of Willis on both the left and right

 

Circle of Willis

Many cerebral arteries are part of a vascular circuit of cerebral blood vessels that really run in a circle: the circle of Willis (ring of Willis). This ring or circle connects the blood vessels of the left side to the right side and the anterior to the posterior circulation. The circle of Willis is located at the base of the brain.

This blood vessel circle forms a safety mechanism because if blood flow is lost in one part, the other side can take over. However, not everyone has this security ring installed properly. About 30% of people have a complete circle of Willis.

The blood vessels that belong to the circle of Willis are:

  • Arteria cerebri posterior (ACP) or posterior cerebral artery
  • Arteria cerebri anterior (ACA) or anterior cerebral artery
  • Arteria cerebri media (ACM) or middle cerebral artery
  • Arteria communicans anterior (ACOM) or anterior communicating artery 
  • Arteria carotis interna (ICA) or internal carotid artery
  • Arteria communicans posterior (PComm) or posterior communicating artery

More information about the circle of Willis is on this wikipedia page.

 

The brain seen from below

The cerebral blood vessels we are looking at in the images below lie in the confined space between the floor of the cranial cavity and the bottom of the brain.

In the image below you can see Willis' circle at the top. The names of the arteries are either on the left or on the right, but the arteries can be seen on both sides. Arteria is abbreviated to A. The top images show the same view, but with the brain drawn from below.

It looks like a "doll" pattern with "legs". The circle of Willis is actually a hexagon of blood vessels in the base of the head.

 

front of the forehead

The veins of the brain, the venous drainage area

The drainage of deoxygenated blood, carbon dioxide, lactic acid and other waste products runs through veins. The veins in the brain have two systems; a deeper and a superficial system.

 

Deeper system

The deeper system of veins drains deoxygenated blood from the basal ganglia and structures located deep in the brain and converges behind the midbrain (mesencephalon).

 

Superficial

The brain veins run through cavities (sinuses) located on the surface of the brain, under the skull. The cavities are formed by the two layers of the dura mater:

  • the periosteal layer, on the side of the bone. It forms a whole with the periosteum of the skull
  • the meningial layer, on the side of the brain

There are blood vessels in a number of places between the two layers.

 

In several places the inner layer loosens and bends inward. This creates folds (dural folds) and spaces (dural venous sinuses) between the inner and outer layer.

The sinuses open into a junction of veins: confluens sinuum (from con, together; flŭĕre, to flow), where the following veins merge:

  • sinus sagittalis superior
  • sinus rectus
  • sinus occipitalis
  • left and right transverse sinus

After which the oxygen-poor blood flows further and ends in the internal jugular vein (this runs in the neck).

 

The superficial venous system depicted:

 

 

In case you are aware of your complaints or your failure, you may be able to find out which blood vessel is involved and vice versa.
Download the diagram here with possible complaints in case of failure of the specific cerebral artery:

PDF Diagram Of The Drainage Area Of The Cerebral Arteries And The Possible Complaints In Case Of Failure
PDF – 237,7 KB 40 downloads

Complaints in the event of failure of: Arteria Carotis Interna

Complaints that may occur: 

Complaints in the event of failure of: Arteriae Vertebralis

Blood circulation area:

Cerebellum (little brain) and truncus cerebri (brainstem)

 

Complaints that may occur:

  • Paresis in one or both halves of the body (Loss of strength or partial paralysis)
  • Sensitivity disorder (loss of sensation) in one or both halves of the body
  • Combinations of:
    • vertigo (dizziness)
    • dysarthria (difficulty articulating)
    • diplopia (double vision)
    • dysfagia (swallowing disorder)
    • dysfonia (voice change)
    • ataxia (coordination disorders)
    • balance disorder
    • nausea
    • nystagmus (wiggling eyes)

Complaints in the event of failure of: Arteria Cerebri Media (ACM)

Blood circulation area:

Side of the frontal lobes /

Parietal lobes

Cortex of the temporal lobes

 

Complaints that may occur:

  • Hemiplegia (paralysis) of the contralateral side, affecting the lower part of the face, arm and hand, while the leg is largely unaffected
  • Contralateral (opposite) sensory loss in similar areas
  • Contralateral homonymous hemianopia visual field disorders, affecting the similar half of the visual field in both eyes
  • Muscle tension too low

  • Spasticity

  • Agnosia
  • Afasia

Complaints in the event of failure of: Arteria Cerebri Anterior (ACA)

Blood circulation area:

Frontal lobes

Parietal lobes

 

 

Complaints that may occur:

Complaints in the event of failure of: Arteria Basilaris

blood circulation area: 

brainstem
occipital lobe
cerebellum


possible complaints:
loss of consciousness/coma
disturbed or irregular breathing
locked-in syndrome
dysarthria
dysphonia
dysphagia
compulsive laughing or compulsive crying (pseudobilbar affect)

Complaints in the event of failure of: Arteria Posterior Communicans

Blood circulation area: 

medial surface of the thalamus and the walls of the third ventricle

Possible complaints: see this page

Complaints in the event of failure of: Arteria Cerebelli Posterior Inferior (PICA)

Blood circulation area: 

Cerebellum (little brain), Plexus chorioides of the fourth ventricle and the dorsolateral part of the medulla oblongata

 

Complaints that may occur:

  • Acute dizziness (vertigo)
  • Nausea
  • Eyes wiggling back and forth (nystagmus): due to damage to the vestibular nuclei. on the same side of the injury (ipsilateral) half-sided coordination problems (hemiataxia). on the same side of the injury (ipsilateral)

 

  • Horner syndrome:
    • miosis (contracted pupil)
    • ptosis (drooping of the upper eyelid)

Complaints in the event of failure of: Arteria Cerebelli Posterior (ACP)

Blood circulation area: 

Occipital lobes

Dorsal side of Temporal lobes

 

 

Complaints that may occur:

  • Homonymous hemianopia (visual field loss) in a quadrant or half of the eyes
  • Cortical blindness: blindness with intact pupillary reflexes to light
  • Often the person does not fully realize the blindness
  • Faceblindness problems  (prosopagnosie)
  • Acute memory problems due to damage to the medial temporal lobe containing the hippocampus: especially in infarctions of the dominant hemisphere 
  • Behavioural problems

Blood circulation in the skull

The bony skull doesn't receive blood from any of the four cerebral arteries, but from the middle meningeal artery.

 

Blood flow to the scalp

The scalp receives blood from the posterior auricular artery (near the ear), occipital artery (near the back of the head) and from the superficial temporal arteries (near the temples). In addition, the scalp receives blood from the two branches of the internal carotid artery, supra-orbital and supratrochlear.

Blood Supply Of Brain
PDF – 1,6 MB 61 downloads
Clinical Consequences
PDF – 1,9 MB 65 downloads

Resources

  • Adams RD, Victor M, Ropper AH. Cerebrovascular Disease. In: Adams RD, Victor M, Ropper AH, editors. Principles of Neurology. New York: McGraw-Hill, Health Professions Division, 1997: 777-873.
  • Bogousslavsky J, Regli F. Anterior cerebral artery territory infarction in the Lausanne Stroke Registry. Clinical and etiologic patterns. Arch Neurol 1990; 47(2):144-150
  • Bastiaanssen, C.A. & Jochems, A.A.F. (1998). Anatomie en fysiologie (4de druk). Houten: Bohn Stafleu Van Loghum
  • Campbell A, Brown A, Schildroth C, et al. The relationship between neuropsychological measures and self-care skills in patients with cerebrovascular lesion. J Natl Med Assoc 1991; 83: 321324.Crossman AR, Neary D. Neuroanatomy: an illustrated colour text (2ndEd). Churchill Livingston, Harcourt Publishers Limited, London, England 2000.
  • His (1895). Die anatomische Nomenclatur. Nomina Anatomica. Der von der Anatomischen Gesellschaft auf ihrer IX. Versammlung in Basel angenommenen Namen. Leipzig: Verlag von Veit & Comp.
  • Kessels, R. , Eling, P. , Ponds, R., Spikman, J. & Zandvoort, M. van (Red.) (2012). Klinische neuropsychologie. Amsterdam: Uitgeverij Boom.
  • Kiernan JA. Blood Supply of the Central Nervous System. In: Kiernan JA, editor. Barr's The human nervous system: an anatomical viewpoint. Philadelphia: Lippincott-Raven, 1998: 439-455
  • Federative Committee on Anatomical Terminology (FCAT) (1998). Terminologia Anatomica. Stuttgart: Thieme
  • Wolters, E.C. & Groenenwegen, H.J. (1996). Neurologie. Structuur, functie en dysfunctie van het zenuwstelsel. Houten/Diegem: Bohn Stafleu Van Loghum.

 

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