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
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Arterial Territories of the Human Brain
Laurent Tatua,b · Thierry Moulinc · Fabrice Vuilliera-c · Julien Bogousslavskyd
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
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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. ...