Arterial Blood Supply & Venous
Drainage of the Brain
Amadi O. Ihunwo, PhD
School of Anatomical Sciences
1
Lecture outline
• Introduction
• Sources of Blood supply
• Internal carotid artery
• Vertebral artery
• Circle of Willis
• Blood supply to spinal cord
• Introduction to Venous Drainage
• Clinical Anatomy
2
Human Brain
• Weight constitute 2 - 2.5%
of body weight
• Receives about 15% or ⅟6 of
cardiac output (approx. 750
ml of blood/minute)
• Utilizes approx. 20-25% or
⅟5 of total oxygen of whole
body
3
• High metabolic rate
Sources of supply
• 2 pairs of arterial trunks
which form a complex
anastomosis (circle of
Willis)
• Internal carotid artery
• Forebrain & occipital lobe of
cerebrum
• Vertebral artery
• Occipital lobe, brainstem &
cerebellum, upper spinal cord 4
Internal Carotid Artery
• Origin
• Bifurcation of common carotid artery
• Course
• Extracranial part enters cranial cavity
via carotid canal
• Intracranial S-shape curve called
carotid siphon
• Petrous part of temporal bone
• Side of sphenoid & within cavernous
sinus in close relation with CN III, IV, V
& VI, reaches base of brain lateral to
optic chiasm
• cerebral course pierces dura mater to
reach anterior perforated space 5
Extracerebral Branches of Internal Carotid Artery
• Petrous part
• Caroticotympanic to tympanic
cavity
• Pterygoid artery to pterygoid
canal
• Cavernous part
• Cavernous brs
• Meningeal brs
• Hypophysial brs
• After cavernous course
• Ophthalmic to contents of
orbital cavity 6
Cerebral branches
• Choroidal
• Anterior cerebral
• Middle cerebral
• Choriodal
• Choroidal plexus, globus
pallidus, posterior limb of
internal capsule, optic tract
and radiation, hippocampus
7
Anterior cerebral
• Smaller terminal br. of ICA
• Cortical branches
• medial surface & marginal area of
superolateral surfaces of cerebrum
• Central branches
• rostrum of corpus callosum, septum
pellucidum, putamen, head of nucleus
8
Middle cerebral artery
Larger terminal branch of ICA
Cortical:
superolateral surface & temporal pole
Central: 2 sets
Medial striate: caudate nucleus,
internal capsule, lentiform nucleus
Lateral striate: caudate nucleus
Charcot’s artery of cerebral
haemorrhage – largest & most
frequently ruptured in apoplexy
Posterior communicating 9
Vertebral Artery
• Origin
• First part of subclavian artery
• Course
• Prevertebral, vertebral, atlantic,
intracranial
• Transverse foramen of C6 to C1 vertebrae
• Foramen magnum
• Ends at lower border of pons by joining
opposite vertebral artery to form basilar
artery
10
Branches of vertebral artery
Posterior spinal
Dorsal 1/3rd spinal cord & DRGs
Anterior spinal
Ventral 2/3rd spinal cord
Posterior inferior cerebellar
Largest branch & supplies
cerebellum
Medullary
Medulla oblongata
Basilar
Formed by union of vertebral
arteries
11
Branches of Basilar artery
Anterior inferior cerebellar (AICA)
Inferior surface of cerebellum
*Labyrinthine (internal auditory) ICA
Internal ear
Pontine
pons PC
Superior cerebellar (SC) SC
Superior surface of cerebellum and } Pontine
anastomose with AICA
AICA *
Posterior cerebral (PC)
PICA
12
Posterior cerebral
• Terminal br. of basilar
• Cortical
• inferior surface of cerebrum, occipital
pole (visual cortex)
• Central
• thalamus, 3rd ventricle, globus pallidus
• Posterior choriodal
• choroid plexus of lateral ventricle,
thalamus, fornix & tectum of midbrain
13
Circle of Willis
Arterial anastomosis
connecting
vertebrobasilar &
internal carotid systems
Location:
Base of interpeduncular fossa
Branches Involved
Anterior communicating
Anterior cerebral
Internal carotid
Posterior communicating
Posterior cerebral
14
Importance of circle of Willis
• Serves to equalise blood flow to various parts of brain
• maintaining a constant supply of oxygen & glucose even when a
contributing artery is narrowed or in head movements
• Furnishes collateral circulation in cases of occlusion of one or
more of arteries contributing to circle
15
Brain angiogram
16
Blood supply to spinal cord
• At medulla, vertebral arteries give off anterior
spinal artery (ASA)
• 10 to 12 segmental (medullary) arteries (brs of
aorta) join anterior spinal artery
• Vertebral arteries (or PICA) give rise to paired
posterior spinal arteries (PSA) that run along dorsal
surface. 17
Disorder of blood supply to spinal cord
• Most vulnerable in
thoracic region & anterior
part of spinal cord
• Occlusion of anterior
spinal artery leads to
acute thoracic cord
syndrome with paraplegia
& incontinence
[Link]/images/[Link]
Venous Drainage of brain
Characteristic Features
• No valves
• Extremely thin walls
• Lack muscular tissue in tunica media
• Pierce arachnoid mater & inner layer of dura mater
• End in dural venous sinuses
19
Three sets of veins
• Superficial veins
• Deep veins
• Dural venous sinuses
Superficial & Deep veins
• Superficial veins within
subarachnoid space
• Superior cerebral - SSS
• Superficial middle
cerebral – CS
• Inferior cerebral - empty
into SSS, TrS & SS
• Superior & inferior
cerebellar into TrS & SS
• Deep veins
• Thalamostriate +
choroidal = internal
cerebral (2)+ basal = great
cerebral (of Galen) + ISS =
straight sinus
Dural Venous Sinus
Between the 2 layers of
dura mater
Namely
Superior sagittal sinus
Inferior sagittal sinus
Straight sinus
Transverse sinus
Occipital sinus
Cavernous &
intercavernous sinus
Superior petrosal sinus
Inferior petrosal sinus
Review location, termination and whether single or paired
Clinical Anatomy
One of the most common
cause of neurological disability
is Stroke (Ischemic or
hemorrhagic)
Sudden occlusion of a cerebral
artery leading to death of brain
tissue (Infarction)
Cerebral haemorrhage
Aneurysm – abnormal ballon-
like swelling of an artery which
may rupture & blood enters
subarachnoid space
(subarachnoid haemorrhage)
or into brain (intracerebral
haemorrhage)
[Link]/.../understand_stroke.html
Questions
• Use a well labelled diagram to show the branches of the
arterial blood supply to the brain
• Enumerate the branches involve in the ‘Circle of Willis’. Add a
note on the clinical significance of the Circle of Willis
• Draw a diagram of the cerebral hemispheres showing the
areas supplied by the cerebral arteries
• Describe the blood supply to the spinal cord
• What are the characteristic features of the veins of the brain.
• How is the great cerebral vein (of Galen) formed and where
does it terminate
• List the dural venous sinuses
