Manifestations of Stroke

M. Paciaroni, G. Agnelli, V. Caso, J. Bogousslavsky

• Publisher: S. Karger
• Year: 2012
• ISBN:
  9783805599115
• Topic: Medicine
• Subtopic: Neurosurgery

Stroke is the most common neurologic disease and the leading cause of adult disability in Western countries. The initial diagnosis of stroke is clinical and needs to be done as rapidly as possible to guarantee optimal medical and interventional therapy. The emergency stroke management depends heavily upon stroke scores to quantify the damage and to speed up the diagnosis process. Unfortunately, several important stroke syndromes are not taken into consideration in these currently used stroke scores and therefore tend to be overlooked and not treated. Compiled by leading international experts, this book provides an excellent overview on current stroke syndromes, including particularly problematic clinical pictures. Thus, together with stroke scores, the publication will lead to more thorough assessments in emergency settings. This book is indispensable for neurologists, neurosurgeons, neuroradiologists and physicians involved in the care of stroke patients.

Topographic Syndromes

Paciaroni M, Agnelli G, Caso V, Bogousslavsky J (eds): Manifestations of Stroke.
Front Neurol Neurosci. Basel, Karger, 2012, vol 30, pp 99-110

______________________

Arterial Territories of the Human Brain

Laurent Tatu^a,b · Thierry Moulin^c · Fabrice Vuillier^a-c · Julien Bogousslavsky^d

^aLaboratoire d'Anatomie, UFR Sciences Médicales et Pharmaceutiques, Université de Franche-Comté, Besançon ^bService d'Explorations et Pathologies Neuromusculaires, et ^cService de Neurologie 2, CHU Jean Minjoz, Besançon, France; ^dCenter for Brain and Nervous System Disorders, and Neurorehabilitation Services, Genolier Swiss Medical Network, Clinique Valmont, Montreux, Switzerland

______________________

Abstract

We present a brain map of the areas supplied by various arteries in the brainstem, cerebellum and cerebral hemispheres. Arterial territories are depicted in a form that is directly applicable to neuroimaging slices in clinical practice. The arterial territories are outlined based on an extensive overview of anatomical studies of cerebral blood supply. For arterial territories of the hemispheres, we present the variability of the cortical territories of the three main cerebral arteries and define the minimal and maximal cortical supply areas.

Copyright © 2012 S. Karger AG, Basel

In this chapter, we present a brain map of the areas supplied by various arteries in the brainstem, cerebellum and cerebral hemispheres. Arterial territories are depicted in a form that is directly applicable to neuroimaging slices in clinical practice. The map is presented on a series of 24 templates, based on a bicommissural plane passing through the center of the anterior and posterior commissures. The sections of the brainstem and cerebellum (sections I-XII) are 4 mm thick, whereas those of the cerebral hemispheres (sections XIII-XXIV) are 8 mm thick. The anatomical structures are shown on the right side of the sections and the arterial territories appear on the left.

Morphological data for the 24 sections are based on anatomical atlases by Duvernoy [1-3]. The arterial territories are outlined based on an extensive overview of anatomical studies of cerebral blood supply. This overview included either vascular injection studies or microanatomic studies of the cerebral arteries, and is developed in more detail elsewhere [4-6]. For arterial territories of the hemispheres, we have chosen to explain in detail the variability of the cortical territories of the three main cerebral arteries and to define the minimal and maximal cortical supply areas with reference to a baseline anatomical study [7].

This chapter is intended to provide a graphical overview of the anatomy of the cerebral arteries. A more detailed approach can be found elsewhere [8].

Arterial Supply of the Brainstem

Arterial trunks supplying the brainstem include the vertebral artery, basilar artery, anterior and posterior spinal arteries, posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, posterior cerebral artery, and anterior choroidal artery. The collaterals of these arteries are divided into four arterial groups (anteromedial, anterolateral, lateral and posterior) according to their point of penetration into the parenchyma. Each of these groups supplies the corresponding arterial territories in the brainstem. The arterial territories have a variable extension at different levels of the brainstem.

Fig. 1. Sections I-XII: arterial territories mapping: brainstem and cerebellum. For abbreviations and color codes see pp. 105-107.

Fig. 2. ...