Anterior spinal artery | |
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Details | |
Source | Vertebral arteries |
Vein | Anterior spinal veins |
Identifiers | |
Latin | arteria spinalis anterior |
TA98 | A12.2.08.016 |
TA2 | 4525 |
FMA | 50531 |
Anatomical terminology |
In human anatomy, the anterior spinal artery is the artery that supplies the anterior portion of the spinal cord. It arises from branches of the vertebral arteries and courses along the anterior aspect of the spinal cord. It is reinforced by several contributory arteries, especially the artery of Adamkiewicz.
The anterior spinal artery arises bilaterally as two small branches near the termination of the vertebral arteries. One of these vessels is usually larger than the other, but occasionally they are about equal in size.[ citation needed ]
Descending in front of the medulla oblongata, they unite at the level of the foramen magnum. The single trunk descends in the front of the medulla spinalis, extending to the lowest part of the medulla spinalis. It is continued as a slender twig on the filum terminale. The vessel passes in the pia mater along the anterior median fissure.[ citation needed ]
On its course the artery takes several small branches (i.e. anterior segmental medullary arteries), which enter the vertebral canal through the intervertebral foramina. These branches are derived from the vertebral artery, the ascending cervical artery, a branch of the inferior thyroid artery in the neck, the intercostal arteries in the thorax, and from the lumbar artery, iliolumbar artery and lateral sacral arteries in the abdomen and pelvis.[ citation needed ]
It supplies the pia mater, and the substance of the medulla spinalis, also sending off branches at its lower part to be distributed to the cauda equina.[ citation needed ]
Disruption of the anterior spinal artery leads to bilateral disruption of the corticospinal tract, causing motor deficits, and bilateral disruption of the spinothalamic tract, causing sensory deficits in the form of pain/temperature sense loss. It is called anterior spinal artery syndrome. This occurs when the disruption of the anterior spinal artery is at the level of the spinal cord. Contrast this with medial medullary syndrome, when the anterior spinal artery is occluded at the level of the medulla oblongata.[ citation needed ]
Disruption of its perforating branches (sulcal artery) can result in a hemicord syndrome. In fact, acute sulcal artery syndrome should be suspected in patients with acute hemicord syndrome, and vertebral artery dissection should be suspected in cases of high cervical cord involvement. In a recent review by Tan YJ, et al. in 2021, good functional recovery was seen in most, and vertebral artery dissection was the leading cause of sulcal artery syndrome. [1]
The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involuntary) functions, ranging from vomiting to sneezing. The medulla contains the cardiac, respiratory, vomiting and vasomotor centers, and therefore deals with the autonomic functions of breathing, heart rate and blood pressure as well as the sleep–wake cycle.
The brainstem is the stalk-like part of the brain that interconnects the cerebrum and diencephalon with the spinal cord. In the human brain, the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch.
A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. These are grouped into the corresponding cervical, thoracic, lumbar, sacral and coccygeal regions of the spine. There are eight pairs of cervical nerves, twelve pairs of thoracic nerves, five pairs of lumbar nerves, five pairs of sacral nerves, and one pair of coccygeal nerves. The spinal nerves are part of the peripheral nervous system.
The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral cortex and terminate either in the brainstem (corticobulbar) or spinal cord (corticospinal) and are involved in the control of motor functions of the body.
In neuroanatomy, dura mater is a thick membrane made of dense irregular connective tissue that surrounds the brain and spinal cord. It is the outermost of the three layers of membrane called the meninges that protect the central nervous system. The other two meningeal layers are the arachnoid mater and the pia mater. It envelops the arachnoid mater, which is responsible for keeping in the cerebrospinal fluid. It is derived primarily from the neural crest cell population, with postnatal contributions of the paraxial mesoderm.
Medial medullary syndrome, also known as inferior alternating syndrome, hypoglossal alternating hemiplegia, lower alternating hemiplegia, or Dejerine syndrome, is a type of alternating hemiplegia characterized by a set of clinical features resulting from occlusion of the anterior spinal artery. This results in the infarction of medial part of the medulla oblongata.
In human anatomy, the artery of Adamkiewicz is the largest anterior segmental medullary artery. It typically arises from a left posterior intercostal artery at the level of the 9th to 12th intercostal artery, which branches from the aorta, and supplies the lower two-thirds of the spinal cord via the anterior spinal artery.
The vertebral arteries are major arteries of the neck. Typically, the vertebral arteries originate from the subclavian arteries. Each vessel courses superiorly along each side of the neck, merging within the skull to form the single, midline basilar artery. As the supplying component of the vertebrobasilar vascular system, the vertebral arteries supply blood to the upper spinal cord, brainstem, cerebellum, and posterior part of brain.
The conus medullaris or conus terminalis is the tapered, lower end of the spinal cord. It occurs near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower. The upper end of the conus medullaris is usually not well defined, however, its corresponding spinal cord segments are usually S1–S5.
The posterior inferior cerebellar artery (PICA) is the largest branch of the vertebral artery. It is one of the three main arteries that supply blood to the cerebellum, a part of the brain. Blockage of the posterior inferior cerebellar artery can result in a type of stroke called lateral medullary syndrome.
The anterior median fissure of the spinal cord is a deep midline groove of the anterior/ventral spinal cord. It divides the white matter of the anterior spinal cord nearly in two. The spinal pia mater extends into the fissure to line the surfaces of the spinal cord.
The posterior spinal artery arises from the vertebral artery in 25% of humans or the posterior inferior cerebellar artery in 75% of humans, adjacent to the medulla oblongata. It is usually double, and spans the length of the spinal cord. It supplies the grey and white posterior columns of the spinal cord.
In neuroanatomy, the medullary pyramids are paired white matter structures of the brainstem's medulla oblongata that contain motor fibers of the corticospinal and corticobulbar tracts – known together as the pyramidal tracts. The lower limit of the pyramids is marked when the fibers cross (decussate).
Anterior spinal artery syndrome is syndrome caused by ischemia of the anterior spinal artery, resulting in loss of function of the anterior two-thirds of the spinal cord. The region affected includes the descending corticospinal tract, ascending spinothalamic tract, and autonomic fibers. It is characterized by a corresponding loss of motor function, loss of pain and temperature sensation, and hypotension.
The medial vestibular nucleus is one of the vestibular nuclei. It is located in the medulla oblongata.
Segmental medullary arteries are arteries of varying size in the thoracolumbar region that arise from segmental arteries of this region and pass through intervertebral foramina to supply the spinal cord. They may join the anterior spinal artery.
Cervical artery dissection is dissection of one of the layers that compose the carotid and vertebral artery in the neck (cervix). They include:
Vascular myelopathy refers to an abnormality of the spinal cord in regard to its blood supply. The blood supply is complicated and supplied by two major vessel groups: the posterior spinal arteries and the anterior spinal arteries—of which the Artery of Adamkiewicz is the largest. Both the posterior and anterior spinal arteries run the entire length of the spinal cord and receive anastomotic (conjoined) vessels in many places. The anterior spinal artery has a less efficient supply of blood and is therefore more susceptible to vascular disease. Whilst atherosclerosis of spinal arteries is rare, necrosis in the anterior artery can be caused by disease in vessels originating from the segmental arteries such as atheroma or aortic dissection.
The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone) of vertebrate animals. The center of the spinal cord is hollow and contains a structure called central canal, which contains cerebrospinal fluid. The spinal cord is also covered by meninges and enclosed by the neural arches. Together, the brain and spinal cord make up the central nervous system.
Babinski–Nageotte syndrome is an alternating brainstem syndrome. It occurs when there is damage to the dorsolateral or posterior lateral medulla oblongata, likely syphilitic in origin. Hence it is also called the alternating medulla oblongata syndrome.
This article incorporates text in the public domain from page 579 of the 20th edition of Gray's Anatomy (1918)