Case 1: Discussion Continued

Why know the vascular territories?

It is important to know the vascular territories of the major blood vessels that supply blood to the brain. Patients will present with strokes in a particular vascular distribution. In order to figure out why the patient had a stroke, you have to evaluate that particular feeding vessel for a potential abnormality- atherosclerosis, dissection, thrombus etc.

The brain is supplied by the anterior and posterior circulation. The anterior circulation includes the branches of the internal carotid arteries: branches of the anterior cerebral arteries and middle cerebral arteries. The posterior circulation includes the territory supplied by the vertebrobasilar system: vertebral artery, basilar artery, posterior cerebral artery and the superior cerebellar artery. If there an infarct within the anterior circulation, you have to evaluate the carotid arteries. If there is an infarct in the posterior circulation you have toevaluate the vertebral arteries.