cerebral vasculature charlie stagg november 2010 you may want to stop eating your lunch for a...
TRANSCRIPT
Cerebral Vasculature
Charlie StaggNovember 2010
You may want to stop eating your lunch for a while….
The circulation as a whole
Internal Carotid Arteries
Anterior Cerebral a.
Middle Cerebral a.
Internal Carotid a.
Vertebral Arteries
Posterior Cerebral a.
Basilar a
Circle of WillisAnterior Cerebral a.
Middle Cerebral a.Internal Carotid a.
Vertebral a.
Posterior Cerebral a.
Basilar a
Communicating a.
Blood supply - the 3 cerebral arteries
AnteriorMiddle
Posterior
From the internal carotid
From the vertebral a.
LATERAL MEDIAL
You can see them on MRI (whether or not you want to….)
Capillaries
Venous Drainage
You can see veins too…
Sagittal sinus
Ischaemic Stroke (80%)
• Atherothromboembolism
• Cardioembolism
• Small vessel disease
• Arterial dissection
• (Rare stuff)
Atherothromboembolism
• Athero - – Soft gruel-like deposit (cholesterol)
• - thrombo - – Blood clot
• -embolism– a mass of clotted blood or other material brought
by the blood from one vessel and forced into a smaller one, obstructing the circulation
Atherothromboembolism
stenosis
Stroke Treatment - “Brain Attack Principle”
• Event-to-needle time 3h
• Acute CT Head
• Clot busting drugs
Stroke Treatment - for the others
• Admission to a stroke unit mortality by 30%• Physiotherapy• Occupational Therapy• Good rehabilitation….
• Secondary Prevention - blood pressure, stop smoking, check for diabetes etc.
Sub-arachnoid haemorrhage
• Sudden onset “worst-ever headache”• Young, fit people.
Nasty Picture Alert