Clinical Question: Anterior or Posterior Circulation Stroke?

00:01 When we're evaluating stroke patients and looking for blood clots in this arterial supply, we ask a series of questions, 2, 3 or sometimes 4 questions to sort through what's going on with the patient.

00:13 These are clinical questions that we ask the first thing when we're evaluating a stroke patient.

00:18 And the first question that I ask is, Is this an anterior or posterior circulation stroke? When we're thinking about anterior circulation strokes, as you see here, we're thinking about strokes that occur in certain vascular territories.

00:33 Anterior circulation strokes will affect the ACA the (anterior cerebral artery), the MCA (middle cerebral artery), and that ACA-MCA (Watershed), the connection in between those.

00:44 We also see anterior circulation supplied blood supply to the subcortical structures, basal ganglia, and the capsular region where there are motor fibers descending to the rest of the body.

00:58 If we take a closer look at anterior circulation, this is the anterior circulation.

01:03 The middle cerebral artery is going to provide blood flow to the temporal lobes, the frontal and parietal lobes.

01:09 The anterior cerebral artery is going to course along the parasagittal region, the middle aspect of the frontal lobe.

01:18 From a posterior circulation standpoint, there are different arteries that are affected by posterior circulation strokes.

01:25 The PCA which provides blood flow to the occipital regions and supports vision.

01:31 The PCA-MCA (Watershed) which is important for watershed ischemia.

01:35 The brainstem cerebellum and then the dominant area of the thalamus.

01:41 And here we can see in a closer appearance that posterior circulation and can understand that blockages in the posterior circulation will affect the brainstem, the cerebellum and the occipital cortices, depending on which artery is affected.