Vascular Diseases Of The Spinal Cord

Blood supply to the spinal cord is complex; the main vessels are the anterior and posterior spinal arteries.

The posterior spinal arteries:---

usually arise from the posterior inferior cerebellar \

arteries and form a plexus v on the posterior surface of the spinal cord.

The anterior spinal artery:---

branches from each vertebral artery unite to form a single vessel lying in the median fissure of the spinal cord.

Basilar artery

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rv

"Vj vr.

Posterior inferior cerebellar artery

• Vertebral artery

Vertebral artery

Both anterior and posterior spinal arteries run the length of the spinal cord and receive anastomotic vessels.

The plexus of the posterior spinal artery is joined by approximately 12 unpaired radicular feeding arteries. This rich collateral circulation protects the posterior part of the spinal cord from vascular disease.

The anterior spinal artery has a much less efficient collateral supply and is thus more vulnerable to the effects of vascular disease. It is joined by 7-10 unpaired radicular branches, usually from the left side.

Cervical arteries arise from vertebral and subclavian vessels, form plexuses and supply the cervical and upper thoracic cord.

Intercostal artery branches supply the midthoracic cord.

v Anterior spinal artery is at its narrowest at T8. This level of the spinal cord is liable to damage during hypertension - watershed area.

N Artery of Adamkiewicz, the largest radicular artery, supplies the low thoracic and lumbar cord. It usually arises at T9-L2 level and is on the left side in 70% of the population.

■ Sacral arteries arise from the hypogastric artery and supply the sacral cord and cauda equina. Anterior radicular branches joining anterior spinal artery

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