Posterior circulation

The posterior cerebral circulation (or simply, posterior circulation) is the blood supply to the posterior portion, including the occipital lobes, cerebellum and brainstem.

The posterior circulation consists of the 2 vertebral artery, basilar artery, 2 posterior cerebral artery, and their branches 1) From these main vessels, many smaller vessels supply the posterior structures of the brain, including:

Posterior inferior cerebellar artery

Anterior inferior cerebellar artery

Superior cerebellar artery

This is the only vascular region in the body where 2 arteries unite to form a large arterial trunk that again divides in 2 major branches.

Fetal circulation: 15–35% of patients supply their posterior cerebral artery on one or both sides primarily from the carotid (via p-comm) instead of via the vertebrobasilar system.


Data indicate that congenital cerebrovascular variants in the posterior circulation and the associated cerebral hypoperfusion may be a factor in triggering arterial hypertension. Therefore, lowering blood pressure may worsen cerebral perfusion in susceptible individuals 2).


1)
Easton DJ, Fauci AS, Isselbacher KJ. Cerebrovascular disease. In: Anonymous Harrison's Principle of Internal Medicine. Fauci AS, Longo D, Kasper DL, Wilson JD, Martin JB, eds. New York, NY: McGraw Hill; 1998:2325–2348
2)
Warnert EA, Rodrigues JC, Burchell AE, Neumann S, Ratcliffe LE, Manghat NE, Harris AD, Adams Z, Nightingale AK, Wise RG, Paton JF, Hart EC. Is High Blood Pressure Self-Protection for the Brain? Circ Res. 2016 Dec 9;119(12):e140-e151. Epub 2016 Sep 26. PubMed PMID: 27672161.
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