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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.
Idiopathic Sudden Sensorineural Hearing Loss
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Isolated case series have reported that patients with sickle-cell anaemia and Waldenstrom macroglobulinaemia have a higher risk of SSNHL, but this is usually reversible with treatment.29,30 Strokes involving the anterior inferior cerebellar artery are associated with auditory and vestibular symptoms, but also cerebellar symptoms. The risk of stroke is also said to be higher in the SSNHL population.31 In addition, SSNHL following cardiopulmonary bypass has also been reported.32 Many of these are small studies, however, and there is a lack of experimental, histological and clinical evidence to support this theory.
Brain regions, lesions, and stroke syndromes
Published in Christos Tziotzios, Jesse Dawson, Matthew Walters, Kennedy R Lees, Stroke in Practice, 2017
Christos Tziotzios, Jesse Dawson, Matthew Walters, Kennedy R Lees
The midline basilar artery runs up in front of the pons to give off the small pontine branches, which supply, as their name betrays, the pons. The anterior inferior cerebellar artery and the labyrinthine artery are also branches of the basilar artery and supply anterior and inferior cerebellum and inner ear, respectively. The basilar artery ascends up and ends at the upper end of the pons by dividing into the superior cerebellar branches just before giving rise to the posterior cerebral arteries. The former supplies the remaining superior part of the cerebellum, as well as the mesencephalon and upper pons. The posterior cerebral artery supplies the visual cortex of the occipital lobe (but the macula can be MCA-supplied). The inferomedial portion of the temporal lobe, posterior and inferior parts of parietal, and the lateral thalamus (via the thalamogeniculate branch) are also supplied by the PCA. It should be noted that the posterior cerebral artery may receive some of its blood from the internal carotid and not the basilar, the basilar artery being a later embryological development. A number of perforating arteries arising from the posterior cerebral or the posterior communicating arteries (see below) supply the anterior part of the midbrain and aspects of subthalamus and hypothalamus. In summary, the posterior cerebral arteries are crucial to the occipital lobes, midbrain, thalamus, and parts of the temporal and parietal lobes.
Treatment of an aberrant inferior temporal artery aneurysm arising off the proximal cavernous segment of the internal carotid artery
Published in British Journal of Neurosurgery, 2023
Yiping Li, Jason Kim, Azam Ahmed
The cavernous (C4) segment of the ICA consists of a posterior vertical, posterior genu, horizontal, and anterior genu.4 The most consistent branches in this segment include meningohypophyseal and inferolateral trunks which provide multiple branches supplying the tentorium, meninges, neurohypophysis, and in rare cases the facial nerve.4,5 The most common variant of the cavernous ICA is a persistent fetal trigeminal artery with an approximate incidence of 0.1–0.5%.6,7 Persistent fetal trigeminal artery is a primitive arterial anastomosis which connects the ICA to the basilar artery and associations with a wide range of cerebrovascular diseases have been reported.5,8 In rare instances the ICA has been reported to give rise to the anterior inferior cerebellar artery, posterior inferior cerebellar artery, and posterior cerebral artery.9–11 In these cases, the incomplete involution of the fetal trigeminal artery may account for the rise of posterior circulation arteries off the ICA.12 To the best of our knowledge, we report the first account of an aberrant artery arising off the proximal cavernous segment of the ICA supplying the medial posterior aspect of the temporal lobe.
Delayed sudden hearing recovery after treatment of a large vertebral artery aneurysm causing hearing loss and imbalance: a case report
Published in British Journal of Neurosurgery, 2022
Eric S. Nussbaum, James K. Goddard, Jodi Lowary, Jenna M. Robinson, Chris Hilton, Leslie A. Nussbaum
Aneurysms causing hearing loss are rare and usually occur in the anterior inferior cerebellar artery (AICA).4,10,14 In 1981, Colclasure et al. described a case report and review of eight published cases of an aneurysm causing hearing loss.12 Aneurysms were located in the AICA in five (56%) cases, the internal carotid artery (ICA) in two (22%) cases, the basilar artery (BA) in one (11%) case, and the posterior communicating artery (PCA) in one (11%) case. Since that review, 17 additional cases have been reported.1–11,13 See Table 1 for a review of these cases. Of these cases, 10 (59%) aneurysms were located in the AICA and three (18%) were located in the ICA. Only two prior cases of a VB aneurysm causing hearing loss have been reported.5,11 In eight (47%) cases, treatment consisted of microsurgical trapping or clipping. One case was treated with resection and end-to-end reanastomosis. Endovascular therapy was used in five (29%) cases. The remaining three (18%) cases were either treated non-surgically or remained untreated.
Intracranial collaterals and arterial wall features in severe symptomatic vertebrobasilar stenosis
Published in Neurological Research, 2020
Ming Yang, Ning Ma, Liping Liu, Anxin Wang, Jing Jing, Zhikai Hou, Yifan Liu, Xin Lou, Zhongrong Miao, Yongjun Wang
Several limitations of this study should be addressed when interpreting the results. First, the small sample size may reduce its power and increase the possibility of bias. Second, this study included patients exclusively with severe symptomatic vertebrobasilar stenosis; thus, it may be not applicable to asymptomatic patients or patients with mild and moderate stenosis. Third, the dominance of vertebral artery and the anastomosis between posterior inferior cerebellar artery and anterior inferior cerebellar artery may also influence the progression of vertebrobasilar atherosclerosis and bias our results. Fourth, our evaluation of vulnerable plaques and arterial remodeling is a cross-sectional study. An ideal longitudinal cohort study, detecting cerebrovascular events and the changes of plaque features, vessel wall in response to plaque growth, might better elucidate its relationship.