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Printable Handouts
Navigable Slide Index
- Introduction
- Arterial blood supply to the brain
- Circle of Willis
- Perforating branches of the Sylvian artery
- Lepto-meningeal arteries
- Territory supplied by the anterior cerebral artery
- Territory supplied by the middle cerebral artery
- Territory supplied by the posterior cerebral artery
- Lepto-meningeal anastomoses
- Cortical borderzone/watershed areas
- Lepto-meningeal arteries in subarachnoid space
- Perpendicular branches
- Pathophysiology in the case of occlusion
- Cerebral blood flow (1)
- Cerebral blood flow (2)
- Physiological regulation of CBF
- CBF equation
- CPP, CBF, CVR and vessel diameter
- Implication of decrease and increase in CPP
- Mean transit time
- Chronic arterial hypertension and autoregulation
- Modulators of CVR
- CBF reactivity to PaCO2
- CBF reactivity to PaO2
- Autoregulation in relation to PaC02
- Effect of neuronal activity on CBF
- Neural control of CBF
- Cytochrome oxidase activity and vessel density
- Normal resting-state flow-metabolism coupling
- Flow-metabolism coupling in the resting state
- Focal neuronal activation and flow-metabolism
- Effects of reduced CPP
- Major physiological variables and CPP
- Occlusion of a cerebral artery
- Overview of stages 1 - 4 of CPP decrease
- Stage 1: hemodynamic reserve (autoregulation)
- Stage 2
- Stage 2: oligemia
- Stage 3
- Stage 3: severe reversible ischemia (penumbra)
- Stage 4
- Stage 4: irreversible ischemic damage (core)
- Acute MCA occlusion
- Acute proximal MCA occlusion
- Growth of the core after permanent MCA occlusion
- MCA occlusion and systemic blood pressure
- Early post-ischemic hyperperfusion
- Early spontaneous hyperperfusion
Topics Covered
- Anatomy of the cerebral arteries and veins
- Main arterial territories
- Physiological regulation of cerebral blood flow
- Autoregulation of cerebral blood flow in physiological and pathological conditions
- The four stages of haemodynamic impairment in cerebrovascular occlusive disease
- Reperfusion of the ischaemic brain
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Talk Citation
Baron, J. (2022, April 12). Basic anatomy, physiology and pathophysiology of the cerebral circulation for the physician [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 11, 2024, from https://doi.org/10.69645/JXVP5211.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Jean-Claude Baron has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Basic anatomy, physiology and pathophysiology of the cerebral circulation for the physician
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
In my talk, I will first briefly review the Anatomy and then,
the Physiology of the Cerebral Circulation and finish off with the basic Pathophysiology,
as it relates to cerebrovascular diseases.
0:16
Arterial blood is supplied to the brain via the two internal carotid arteries,
and the two vertebral arteries,
the latter merging to form the basilar artery.
0:30
At the base of the brain,
the internal carotid divides to form the anterior and the middle cerebral arteries,
abbreviated as ACA and MCA respectively,
and the basilar artery divides to form the two posterior cerebral arteries PCA.
However, one also finds an anterior communicating artery, ACom,
between the two ACAs and a posterior communicating artery,
PCom, between the ICA and PCA on each side.
As a result, the Circle of Willis is formed,
which allows the anterior and posterior systems,
as well as the right and left sides of the brain
to communicate in terms of arterial blood supply.
Hence, an occlusion of an artery proximal to the Circle of Willis can be
compensated for completely or partially by the remaining arteries.
However, about 50 percent of people have incomplete Circle of Willis.
These persons are at a higher risk of having
more serious strokes from proximal arterial occlusions.
1:38
At the base of the brain,
the arteries of the Circle of Willis send out branches that run
perpendicularly to them and supply the basal ganglia,
thalamus, and deep, white matter.
Similar branches stem from the basilar artery to supply the brainstem.
These arteries are called the perforators.
They do not significantly anastamose and
therefore, their occlusion generally results in a lacunar infarct.
At the surface of the brain, the anterior, middle,
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