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Central nervous system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The brain is supplied with blood from two sources. The bilateral internal carotid arteries arise from the bifurcation of the common carotid arteries in the neck and branch off to form the left and right anterior and middle cerebral arteries, which supply the forebrain. The vertebral arteries arise from the subclavian arteries and come together at the level of the pons to form the midline basilar artery. The posterior cerebral, basilar and vertebral arteries supply the posterior circulation of the brain, comprising posterior cortex, the midbrain and the brainstem. Cerebellum is also supplied by dorsolateral arteries such as the posterior inferior cerebellar artery (PICA) and the anterior inferior cerebellar artery (AICA) and superior cerebellar artery. An arterial ring called the circle of Willis connects the anterior and posterior cerebral circulation; thus, in the event of loss of blood supply to one area of the brain, it may be possible for blood to be supplied via a different arterial route.
Neuroimaging
Published in Sarah McWilliams, Practical Radiological Anatomy, 2011
o The basilar artery is formed from two vertebral arteries: the vertebral arteries are usually the first branch of the subclavian artery and run up through the foramen trans- versarium, looping around C1 and passing up into the foramen magnum. They give rise to the posterior inferior cerebellar artery (PICA) before joining to form the basilar artery.
Braided stents and their impact in intracranial aneurysm treatment for distal locations: from flow diverters to low profile stents
Published in Expert Review of Medical Devices, 2019
Christina Iosif, Alessandra Biondi
Akmangit et al. [81] reported their experience with the Leo Baby stent for dual stenting for very challenging intracranial aneurysms. Twelve patients were included in this study. Five of the 12 aneurysms were located at the anterior communicating artery (AcomA), 2 aneurysms were located at the basilar artery, 1 aneurysm was located at the posterior inferior cerebellar artery, 1 aneurysm was located at the A1 segment of the anterior cerebral artery, and 3 aneurysms were located at the MCA bifurcation. The mean aneurysm size was 9.8 mm. Nine patients were treated by using the dual stent-assisted coiling method. X- (non-intersecting), Y- (intersecting and reversible), T-, and parallel-stent configurations were performed for the dual stent-assisted coiling procedures. Three patients were treated by using telescopic stent placement for a flow diverter–like effect. The procedures were successful in all cases. Technical complications without a significant clinical adverse event developed in two patients. The 3- and 6-month control MRAs and DSAs demonstrated complete occlusion of the aneurysms in all patients except 1. All patients had good clinical outcomes on follow-up (mRS≤1). The authors concluded that dual stent placement with the low-profile LEO Baby stents for distally located complex intracranial aneurysms is feasible, safe and effective.