Figure 33-10. A. Inferior aspect of the left hemisphere showing the branches and distribution of the posterior cerebral artery and the principal anatomic structures supplied. The vessel is considered from the perspective of its proximal and distal territories. Listed below are the clinical manifestations produced by infarction in these territories and the corresponding regions of damage. Tremor in repose has been omitted because of the uncertainty of its occurrence in the posterior cerebral artery syndrome. Peduncular hallucinosis may occur in thalamic-subthalamic ischemic lesions, but the exact location of the lesion is unknown. B. Axial diffusion-weighted MRI showing an acute ischemic infarction in the posterior cerebral artery territory.
Figure 33-11. The posterior cerebral and basilar arteries. A. The terminus of the basilar artery and branches originating from the P1 through P3 segments. (Reproduced by permission from Stroke 34:2264, 2003.) B. Lateral view of the brain showing the branches of the posterior cerebral artery. (Reproduced by permission from Krayenbühl and Yasargil.) C. Axial diffusion-weighted MRI showing an acute ischemic infarction due to occlusion of an artery of Percheron, an anatomic variant, in which an azygos paramedian artery supplies both sides of the posterior-medial thalamus.
Figure 33-9. Diagram of the regions of blood supply of the diencephalon. Distribution of the (1) anterior cerebral artery, (2) posterior cerebral artery, (3) anterior and posterior choroidal arteries, (4) posterior communicating artery, and (5) internal carotid artery. (Reproduced by permission from Krayenbühl and Yasargil.)
Figure 33-12. Regions supplied by the posterior segment of the circle of Willis, lateral view (A) and basal view (B). A. (1) Posterior cerebral artery; (2) superior cerebellar artery; (3) basilar artery and superior cerebellar artery; (4) posterior inferior cerebellar artery; (5) vertebral artery (posterior inferior cerebellar artery, anterior spinal artery, posterior spinal artery). B. (1) Posterior cerebral artery; (2) superior cerebellar artery; (3) paramedian branches of the basilar artery and spinal artery; (4) posterior inferior cerebellar artery; (5) vertebral artery; (6) anterior inferior cerebellar artery; (7) dorsal spinal artery. (Reproduced by permission from Krayenbühl and Yasargil.)
Figure 33-13. Transverse section through the upper medulla, reflecting regions supplied by the vertebral arteries and their branches.
Figure 33-14. Transverse section through the lower pons, reflecting the regions supplied by the lower basilar artery including its anterior inferior cerebellar artery branch.
Figure 33-15. Transverse section through the midpons in the regions supplied by the mid-basilar artery and its short circumferential and paramedian branches.
Figure 33-16. Transverse section through the upper pons and the regions supplied by the upper basilar artery and its superior cerebellar artery branch.
Figure 33-17. Axial diffusion-weighted MRI of acute lacunar infarctions. A. Left capsular infarction causing a right pure motor hemiplegia. B. Left pontine infarction causing a clumsy hand–dysarthria syndrome.
Figure 33-18. Large ischemic infarction of the left cerebral hemisphere mainly in the distribution of the superior division of the middle cerebral artery. CT at 24 h (left) and 72 h (right) following the onset of stroke symptoms. The second scan (right) demonstrates marked swelling of the infarcted tissue and rightward displacement of central structures.