Neurosurgery notes/Anatomy/Brainstem/Brainstem vascular supply

Brainstem vascular supply

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Brainstem

Blood Supply of the Brainstem

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Derived from

  • Vertebral arteries give rise to:
    • Posterior spinal artery
    • Anterior spinal artery
    • Posteroinferior cerebellar artery
  • Basilar Arteries
    • Formed from the vertebral arteries at the ponto-medullary junction
    • Give rise to
      • Anteroinferior cerebellar arteries
      • Superior cerebellar arteries
      • Posterior cerebral arteries
      • Numerous small paramedian and circumferential pontine branches

Branches of the vertebral and basilar arteries may be conceptually subdivided into

  • Paramedian branches → medial brainstem
  • Short circumferential branches → anterolateral brainstem
  • Long circumferential branches → posterolateral brainstem

Midbrain

  • Posterior cerebral artery (Main)
    • Paramedian branches
    • Short circumferential branches
    • Long circumferential branches
  • Others
    • Superior cerebellar artery
      • Short circumferential branches
      • Long circumferential branches
    • Internal carotid artery system
      • Posterior communicating artery → Rostral most midbrain
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Pons

  • Medial basal pons,
    • Includes
      • Corticospinal tract
      • Medial lemniscus
    • Supplied by
      • Paramedian branches of the basilar artery
  • Lateral pons
    • Includes
      • Spinothalamic tract
      • Descending sympathetic fibers,
      • Spinal tract and nucleus of the trigeminal nerve
    • Supplied by basilar artery
      • Rostral: Superior cerebellar artery
      • Caudal: Anteroinferior cerebellar artery
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Medulla

  • Medial portion of the medulla
    • Includes
      • Corticospinal tract
      • Medial lemniscus,
    • Supplied by
      • Cranially: Vertebral artery
      • Very caudally: The anterior spinal artery.
  • Lateral portion of the medulla,
    • Including
      • Spinothalamic tract
      • Descending sympathetic fibers,
      • Spinal tract and nucleus of the trigeminal nerve,
    • Supplied by
      • Vertebral artery
      • Posterior inferior cerebellar artery.
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