Understanding Neurology

Neurological investigations 4943Vertebral arteryL5T1107Cervical arteries arise from vertebraland subclavian vessels, form plexusesand supply the cervical and upperthoracic cordIntercostal artery branches supplythe midthoracic cordAnterior spinal artery is at itsnarrowest at T8. This level of thespinal cord is liable to damageduring hypertension – watershedareaArtery of Adamkiewicz, the largestradicular artery, supplies the lowthoracic and lumbar cord. It usuallyarises around T9–T12 levels and ison the left side in 70% of thepopulationSacral arteries arise from thehypogastric artery and supply thesacral cord and cauda equinaAnterior radicular branches joining anterior spinal artery44Posterior spinal arteryterritory– Posterior one-third ofspinal cord– Dorsal columnVirtually noanastomoticcommunicationAnterior spinal artery territoryPenetrating branches – anterior and part of posterior greymatterCircumferential branches – anterior white matter.– Anterior two-thirds of spinal cord44 Axial figure of the spinal cord, illustrating anterior andposterior spinal artery territories.43 Sagittal diagram of the blood supply to the spinal cord.45 Myelogram showingspondylolisthesis at L4–L5 andL5–S1 with crowding of nerveroots.454646 Coronal computed tomography scan of thespine showing a fracture at C7 not visible onplain X-rays.