Related Subjects:
|Neurological History taking
|Causes of Stroke
|Ischaemic Stroke
|Subarachnoid Haemorrhage
|Small Vessel Disease
|Vascular Dementia
|Capsular and Pontine Warning Syndromes
|Dementias
|CADASIL
|CARASIL
|Cerebral Arterial Perfusion and Clinical Correlates
|Anterior circulation Brain
|Posterior circulation Brain
|Acute Stroke Assessment (ROSIER&NIHSS)
|Carotid Artery dissection
|Vertebral artery dissection
|Acute Stroke Assessment (ROSIER&NIHSS)
|Atrial Fibrillation
|Atrial Myxoma
|Causes of Stroke
|Ischaemic Stroke
|Cancer and Stroke
|Cerebral Venous thrombosis
|Cardioembolic stroke
|CT Basics for Stroke
|Endocarditis and Stroke
|Haemorrhagic Stroke
|Stroke Thrombolysis
|Hyperacute Stroke Care
|AP of the Brain
|Cryptogenic stroke
|Carotid Web
|Anterior / Medial Medullary Infarct (Dejerine Syndrome)
🩸 The vertebral arteries provide about one-third of the cerebral blood supply, forming the vital posterior circulation. Their branches supply the medulla, pons, cerebellum, and occipital lobes - regions critical for life-sustaining functions.
🧭 Vertebral Artery Course
- Arises as the first branch of the subclavian artery on each side.
- Enters the transverse foramen at C6, ascends through the foramina up to C1.
- Curves posteriorly around the atlas and enters the skull via the foramen magnum.
- At the lower border of the pons, the two vertebral arteries unite to form the basilar artery.
🌿 Major Branches
- Posterior Inferior Cerebellar Artery (PICA) 🧠
- Largest branch of the vertebral artery.
- Supplies the lateral medulla and inferior cerebellum.
- Occlusion → Wallenberg’s syndrome (lateral medullary syndrome).
- Anterior Spinal Artery 🟠
- Formed by contributions from both vertebral arteries; supplies ventral medulla and anterior spinal cord.
- Posterior Spinal Artery 🔵
- Supplies dorsal medulla and dorsal columns of spinal cord.
- Basilar Artery 🏗️
- Formed by vertebral fusion; supplies pons, cerebellum, and inner ear.
- Anterior Inferior Cerebellar Artery (AICA) ⚖️
- Supplies lateral pons and anterior inferior cerebellum.
- Superior Cerebellar Artery ⛰️
- Supplies superior cerebellum and lateral pons.
- Pontine Arteries ➕
- About 12 small perforators branching at right angles from the basilar artery to supply the medial pons.
- Internal Auditory (Labyrinthine) Artery 🎧
- Travels with CN VIII to supply the inner ear; infarction can cause sudden hearing loss and vertigo.
- Posterior Cerebral Artery (PCA) 👁️
- Embryologically linked to the internal carotid; later supplied by the basilar.
- Wraps around the cerebral peduncle to supply the occipital lobe and inferior temporal cortex.
🌐 Posterior Cerebral Artery (PCA) Branches
- Postero-medial Ganglionic Branches → thalami + walls of 3rd ventricle.
- Posterior Choroidal Branches → choroid plexus of 3rd ventricle.
- Postero-lateral Ganglionic Branches → lateral thalamus.
- Anterior Temporal Branch → uncus + anterior fusiform gyrus.
- Posterior Temporal Branch → inferior temporal gyri, lingual gyrus, cuneus, occipital cortex.
- Parieto-occipital Branch → parieto-occipital region, calcarine cortex.
🧑⚕️ Clinical Relevance
- 🔸 PICA stroke → Wallenberg’s syndrome (vertigo, ataxia, ipsilateral facial sensory loss, contralateral body sensory loss).
- 🔸 AICA stroke → lateral pontine syndrome (facial weakness, vertigo, hearing loss).
- 🔸 Basilar occlusion → catastrophic brainstem infarction, “locked-in syndrome.”
- 🔸 PCA stroke → contralateral homonymous hemianopia ± alexia without agraphia (if dominant hemisphere, splenium involvement).
