Viiangiography

A. Carotid angiography. Figures 3-5A and B show the internal carotid artery, anterior cerebral artery, and middle cerebral artery.

Superior sagittal

Anter or cerebral

Pca Branches

Superior cerebral veins Superior sagittal sinus Branches of MCA PCA

Straight sinus

Confluence of the sinuses

Transverse sinus Vertebral artery

Figure 3-4. Magnetic resonance angiogram, lateral projection, showing the major venous sinuses and arteries. Note the bridging veins entering the superior sagittal sinus. JCA = internal carotid artery; MCA = middle cerebral artery; PCA = posterior cerebral artery.

Superior cerebral veins Superior sagittal sinus Branches of MCA PCA

Cavernous part of ICA Petrosal part of ICA Basilar

Sigmoid

Straight sinus

Confluence of the sinuses

Transverse sinus Vertebral artery

Superior sagittal

Anter or cerebral

Figure 3-4. Magnetic resonance angiogram, lateral projection, showing the major venous sinuses and arteries. Note the bridging veins entering the superior sagittal sinus. JCA = internal carotid artery; MCA = middle cerebral artery; PCA = posterior cerebral artery.

Middle Cerebral Artery Anatomy

B. Vertebral angiography. Figures 3-5C and D show the vertebral artery, PICA and AICA, basilar artery, superior cerebellar artery, and posterior cerebral artery.

C. Veins and durai sinuses. Figure 3-6 shows the internal cerebral vein, superior cerebral veins, great cerebral vein, superior ophthalmic vein, and major durai sinuses.

D. Digital subtraction angiography. See Figures 3-7, 3-8, 3-9, and 3-10.

VIII. THE MIDDLE MENINGEAL ARTERY, a branch of the maxillary artery, enters the cranium through the foramen spinosum. It supplies most of the dura, including its calvarial portion. Laceration results in epidural hemorrhage (hematoma) [Figures 3-11 and 3-12).

1. Anterior cerebral artery

2. Anterior choroidal artery

3. Anterior inferior cerebellar artery

4. Basilar artery

5. Calcarine artery (of posterior cerebral artery)

6. Callosomarginal artery (of anterior cerebral artery)

7. Callosomarginal and pericallosal arteries (of anterior cerebral artery)

8. Internal carotid artery

9. Lateral striate arteries (of middle cerebral artery)

10. Middle cerebral artery

11. Ophthalmic artery

12. Pericallosal artery (of anterior cerebral artery)

13. Posterior cerebral artery

14. Posterior choroidal arteries (of posteior cerebral artery)

15. Posterior communicating artery

16. Posterior inferior cerebellar artery

17. Superior cerebellar artery

18. Vertebral artery

Figure 3-5. (A) Carotid angiogram, lateral projection. (B) Carotid angiogram, anteroposterior projection. (C) Vertebral angiogram, lateral projection. (I)) Vertebral angiogram, anteroposterior projection.

.Internal cerebral vein

/ Superior sagittal sinus

Inferior sagittal sinus v

Callosomarginal artery of ACA

Pericallosal artery of ACA

Petrous ICA

Cervical ICA

Cavernous sinus

Frontopolar branch of ACA

Ophthalmic artery Cavernous ICA

Superior ophthalmic vein N

Superior Ophthalmic Vein Angiography

MCA M1 segment PCoM

Figure 3-7. Carotid angiogram, lateral projection. Identify the cortical branches of the anterior cerebral artery (ACA) and middle cerebral artery (MCA). Follow the course of the internal carotid artery (JCA). Re-member that aneurisms of the posterior communicating artery may result in third-nerve palsy. The paracentral lobule is irrigated by the callosomarginal artery. Cortical branches of the MCA are designated with dots. PCoM = posterior communicating artery.

Callosomarginal artery of ACA

Pericallosal artery of ACA

Petrous ICA

Cervical ICA

Figure 3-7. Carotid angiogram, lateral projection. Identify the cortical branches of the anterior cerebral artery (ACA) and middle cerebral artery (MCA). Follow the course of the internal carotid artery (JCA). Re-member that aneurisms of the posterior communicating artery may result in third-nerve palsy. The paracentral lobule is irrigated by the callosomarginal artery. Cortical branches of the MCA are designated with dots. PCoM = posterior communicating artery.

.Internal cerebral vein

/ Superior sagittal sinus cerebral veins (bridging veins)

Cavernous sinus

Great cerebral vein (of Galen) - Straight sinus

-Confluence of sinuses -Transverse sinus -Sigmoid sinus

Frontopolar branch of ACA

Ophthalmic artery Cavernous ICA

MCA M1 segment PCoM

Inferior sagittal sinus v

Superior ophthalmic vein N

A1 segment of ACA ACoM

Cavernous part of ICA

Ophthalmic Veins

branches of MCA

Figure 3-8. Carotid angiogram, anteroposterior projection. Identify the anterior cerebral artery (ACA), middle cerebral artery (MCA), and internal carotid artery {ICA). The horizontal branches of the MCA perfuse the basal ganglia and internal capsule. ACoM = anterior communicating artery.

A1 segment of ACA ACoM

Cavernous part of ICA

branches of MCA

striate branches of MCA

M1 segment of MCA Supraclinoid part of ICA Petrous part of ICA Cervical part of ICA

Figure 3-8. Carotid angiogram, anteroposterior projection. Identify the anterior cerebral artery (ACA), middle cerebral artery (MCA), and internal carotid artery {ICA). The horizontal branches of the MCA perfuse the basal ganglia and internal capsule. ACoM = anterior communicating artery.

Vertebral artery

Posterior choroidal arteries

Sca From Pca

Parieto-occipital branches of PCA

Calcarine branches of PCA

Hemispheric branches of SCA

PICA

Vertebral artery

Figure 3-9. Vertebral angiogram, lateral projection. Two structures are found between the posterior cerebral artery (PCA) and the superior cerebellar artery: the tentorium and the third cranial nerve. PCoM = posterior communicating artery; PICA = posterior inferior cerebellar artery; SCA = superior cerebellar artery.

Vertebral artery

Parieto-occipital branches of PCA

PCA, P1 segment

Thalamoperforating arteries

Superior cerebellar artery Basilar artery

Calcarine branches of PCA

Hemispheric branches of SCA

PICA

Vertebral artery

Posterior choroidal arteries

Figure 3-9. Vertebral angiogram, lateral projection. Two structures are found between the posterior cerebral artery (PCA) and the superior cerebellar artery: the tentorium and the third cranial nerve. PCoM = posterior communicating artery; PICA = posterior inferior cerebellar artery; SCA = superior cerebellar artery.

Calcarine artery of PCA

Basilar artery

PICA

Superior cerebellar artery

Calcarine Artery

Temporal branches of PCA

Vertebral artery

Figure 3-10. Vertebral angiogram, anteroposterior projection. Which artery supplies the visual cortex? The calcarine artery, a branch of the posterior cerebral artery (PCA). Occlusion of the PCA (calcarine artery) results in a contralateral homonymous hemianopia, with macular sparing. PICA = posterior inferior cerebellar artery.

Calcarine artery of PCA

Basilar artery

Temporal branches of PCA

Vertebral artery

PICA

Superior cerebellar artery

Figure 3-10. Vertebral angiogram, anteroposterior projection. Which artery supplies the visual cortex? The calcarine artery, a branch of the posterior cerebral artery (PCA). Occlusion of the PCA (calcarine artery) results in a contralateral homonymous hemianopia, with macular sparing. PICA = posterior inferior cerebellar artery.

Falx Hematoma Anterior Cerebral Artery

Outer table

Periosteum (of inner table)

Figure 3-11. An epidural hematoma results from laceration of the middle meningeal artery. Arterial bleeding into the epidural space forms a biconvex clot. The classic "lucid interval" is seen in 50% of cases. Skull fractures arc usually found Epidural hematomas rarely cross sutural lines. (Reprinted with permission from Osbum AG, Tong KA: Handbook of Neuroradiology: Brain and Skull. St. Louis, Mosby, 1996, p. 191.)

Bridging Veins And Nervous System

Figure 3-12. A subdural hematoma (SDH) results from lacerated bridging veins. SDHs are frequently accompanied by traumatic subarachnoid hemorrhages and cortical contusions. Sudden deceleration of the head causes tearing of the superior cerebral veins. The SDH extends over the crest of the convexity into the inter-hemispheric fissure, but does not cross the dural attachment of the falx cerebri. The clot can be crescent-shaped, biconvex, or multiloculated. SDHs are more common than epidural hematomas. SDHs always cause brain damage. (Reprinted with permission from Osbum AG, Tong KA: Handbook of Neuroradiology: Drain and Skull. St. 1.011 is, Mosby, 19%, p. 192.)

Figure 3-12. A subdural hematoma (SDH) results from lacerated bridging veins. SDHs are frequently accompanied by traumatic subarachnoid hemorrhages and cortical contusions. Sudden deceleration of the head causes tearing of the superior cerebral veins. The SDH extends over the crest of the convexity into the inter-hemispheric fissure, but does not cross the dural attachment of the falx cerebri. The clot can be crescent-shaped, biconvex, or multiloculated. SDHs are more common than epidural hematomas. SDHs always cause brain damage. (Reprinted with permission from Osbum AG, Tong KA: Handbook of Neuroradiology: Drain and Skull. St. 1.011 is, Mosby, 19%, p. 192.)

Essentials of Human Physiology

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Responses

  • philipp
    Does the pica communicate with the pcomm?
    7 years ago

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