Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Sep;30(3):234-9.
doi: 10.1055/s-0033-1353475.

Basic vascular neuroanatomy of the brain and spine: what the general interventional radiologist needs to know

Ethan A Prince  1 , Sun Ho Ahn  1
Affiliations
Free PMC article
Review

Basic vascular neuroanatomy of the brain and spine: what the general interventional radiologist needs to know

Ethan A Prince et al. Semin Intervent Radiol. .
Free PMC article
Favorites

Abstract

This article is intended to provide a review of clinically relevant neurovascular anatomy. A solid understanding of the vascular anatomy of the brain and spine are essential for the safe and effective performance of neurointerventional radiology. Key concepts to master include collateral pathways and anastomoses between the external and internal carotid circulation, the Circle of Willis as a route to otherwise inaccessible intracranial vascular distributions, and the origin of spinal arterial blood supply. These concepts will be highlighted using clinical angiographic examples with discussion of relevant embryology and pathology as needed.

Keywords: angiography; interventional radiology; neuroanatomy; neurointerventional radiology.

Figures

Figure 1
Circle of Willis anatomy: Surface volume rendered image from a CT angiography (CTA) showing the anterior communicating artery (open black arrow) and bilateral posterior communicating arteries (open white arrows). Orientation is as though the brain has been removed and we are looking down at the inside of the skull from above.
Figure 2
Cervical internal carotid artery anatomy: Lateral common carotid angiogram showing anatomic segments of the internal carotid artery. Note that there is near complete occlusion of the external carotid artery because of a heavily calcified lesion (open black arrow). The open white arrow denotes the ophthalmic artery.
Figure 3
Anterior circulation anatomy: anteroposterior (AP) right internal carotid angiogram showing divisions of the middle (M) and anterior (A) cerebral arteries. There is reflux into the external branches as well.
Figure 4
Vertebral artery anatomy: AP fluoroscopic image of a patient undergoing treatment of a symptomatic basilar artery stenosis. A microcatheter and guidewire are within the cervical vertebral artery. The small solid black arrow indicates the extraosseous (V1) segment, the large solid black arrow indicates the foraminal (V2) segment, the large open black arrow indicates the extraspinal (V3) segment, and the small open black arrow indicates the intradural (V4) segment.
Figure 5
Posterior circulation anatomy: AP angiogram of the posterior cerebral circulation demonstrating the segments of the posterior cerebral artery; open black arrows show P1 segments, solid black arrows show P2 segments, open white arrows show P3 segments, and solid white arrows show P4 segments. The bilateral superior cerebellar arteries are seen immediately below the posterior cerebrals. Note that the left vertebral artery is slightly larger than the right, consistent with a left dominant vertebrobasilar system (the most common variation).
Figure 6
External carotid artery anatomy: Lateral angiogram in a patient with acute traumatic dissection of the internal carotid artery (open arrow) demonstrating the branches of the ECA. 1, superior thyroidal artery; 2, lingual artery; 3, facial artery; 4, ascending pharyngeal artery; 5, occipital artery; 6, internal maxillary artery; 7, middle meningeal artery; 8, superficial temporal artery.
Figure 7
Figure 7
Anterior spinal artery: AP angiogram demonstrating the typical appearance of the artery of Adamkiewicz (open arrow). Note small somatic branches traveling lateral to medial and paralleling the vertebral body end plate.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by 9 articles

See all "Cited by" articles
Feedback