Anatomy of the Brain's Arterial Supply

Curé, Joel K.

doi:10.1002/9781444327373.ch3

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…From the terminal BA, the PCAs are where the thalamoperforating, thalamogeniculate, and peduncular perforating arteries supply the mesencephalon, diencephalon, and the choroid plexus and walls of the lateral and third ventricles and cerebral branches to the cerebral cortex and callosal splenium. (3). Vas and common branches are shown in Figure 1.…”

Section: Anatomy Of the Posterior Circulation And Relationships With Autonomic Structuresmentioning

confidence: 99%

“…This hemodynamic success is achieved through an active autonomic and neural system composed of the sympathetic and parasympathetic system. During extreme physiological and pathological processes, these systems are activated with the aim to prioritize cerebral blood flow to the VBS to keep its functions intact (3). In recent years, molecular biology, complex animal models, and functional imaging techniques have shown the importance of the sympathetic/parasympathetic balance function and how vascular pathology can disturb normal perfusion.…”

Section: Introductionmentioning

confidence: 99%

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Regulation of Blood Flow in the Cerebral Posterior Circulation by Parasympathetic Nerve Fibers: Physiological Background and Possible Clinical Implications in Patients With Vertebrobasilar Stroke

Tamayo

Siepmann

2021

Front. Neurol.

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Posterior circulation involves the vertebrobasilar arteries, which supply oxygen and glucose to vital human brainstem structures and other areas. This complex circulatory- perfusion system is not homogenous throughout the day; rather, its hemodynamic changes rely on physiological demands, ensuring brainstem perfusion. This dynamic autoregulatory pattern maintains cerebral perfusion during blood pressure changes. Accumulative evidence suggests that activity within the autonomic nervous system is involved in the regulation of cerebral blood flow. Neither the sympathetic nor parasympathetic nervous systems work independently. Functional studies have shown a tight and complicated cross talk between these systems. In pathological processes where sympathetic stimulation is present, systemic vasoconstriction is followed, representing the most important CNS parasympathetic trigger that will promote local vasodilation. Stroke is a clear example of this process. The posterior circulation is affected in 30% of strokes, causing high morbidity and mortality outcomes. Currently, the management of ischemic stroke is focused on thrombolytic treatment and endovascular thrombectomy within an overall tight 4.5 to 6 h ischemic time window. Therefore, the autonomic nervous system could represent a potential therapeutic target to modulate reperfusion after cerebral ischemia through vasodilation, which could potentially decrease infarct size and increase the thrombolytic therapeutic ischemic window. In addition, shifting the autonomic nervous system balance toward its parasympathetic branch has shown to enhance neurogenesis and decrease local inflammation. Regretfully, the vast majority of animal models and human research on neuromodulation during brain ischemia have been focused on anterior circulation with disappointing results. In addition, the source of parasympathetic inputs in the vertebrobasilar system in humans is poorly understood, substantiating a gap and controversy in this area. Here, we reviewed current available literature regarding the parasympathetic vascular function and challenges of its stimulation in the vertebrobasilar system.

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Section: Anatomy Of the Posterior Circulation And Relationships With Autonomic Structuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Regulation of Blood Flow in the Cerebral Posterior Circulation by Parasympathetic Nerve Fibers: Physiological Background and Possible Clinical Implications in Patients With Vertebrobasilar Stroke

Tamayo

Siepmann

2021

Front. Neurol.

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Accidente cerebrovascular isquémico de la arteria cerebral media

Sanabria

Cubillos

2022

Repert. Med. Cir.

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La segunda causa de muerte a nivel mundial corresponde a los ataques cerebrovasculares (ACV), de los cuales más de dos terceras partes son de origen isquémico. Causan discapacidad a largo plazo por lo que conocer la anatomía de la circulación cerebral y las posibles manifestaciones clínicas del ACV isquémico permite sospechar, diagnosticar y brindar un manejo oportuno y apropiado, reduciendo el impacto en la salud y la calidad de vida del paciente y sus cuidadores. Objetivo: relacionar los últimos hallazgos en la anatomía arterial cerebral, los mecanismos fisiopatológicos y las manifestaciones clínicas del ACV isquémico de la arteria cerebral media (ACM). Materiales y métodos: revisión de la literatura mediante la búsqueda con términos MeSH en la base de datos Medline, incluyendo estudios, ensayos y metaanálisis publicados entre 2000 y 2020 en inglés y español, además de otras referencias para complementar la información. Resultados: se seleccionaron 59 publicaciones, priorizando la de los últimos 5 años y las más relevantes del rango temporal consultado. Conclusiones: son escasos los estudios sobre la presentación clínica de los ACV, lo que sumado a la variabilidad interindividual de la irrigación cerebral, dificulta la determinación clínica de la localización de la lesión dentro del lecho vascular. La reperfusión del área de penumbra isquémica como objetivo terapéutico se justifica por los mecanismos fisiopatológicos de la enfermedad.

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Anatomy of the Brain's Arterial Supply

Cited by 2 publications

References 23 publications

Regulation of Blood Flow in the Cerebral Posterior Circulation by Parasympathetic Nerve Fibers: Physiological Background and Possible Clinical Implications in Patients With Vertebrobasilar Stroke

Regulation of Blood Flow in the Cerebral Posterior Circulation by Parasympathetic Nerve Fibers: Physiological Background and Possible Clinical Implications in Patients With Vertebrobasilar Stroke

Accidente cerebrovascular isquémico de la arteria cerebral media

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