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The vertebral arteries, basilar trunk and their branches provide the vascular supply to the brainstem and cerebellum. The anatomy of these arteries has been studied by STOPFORD (1917), FOIX and HILLEMAND (1925) and LAZORTHES, POULHES and ESPAGNO (1950).

Based upon dissections of 150 human brains in which the arteries of interest were selectively injected, we have evaluated the origin, course, and each cortical branch of the cerebral arteries to see if it would be possible to precisely define their vascular territories. This work was especially detailed for the anterior and middle cerebral arteries. It was quite evident that each cortical branch of a cerebral artery has a characteristic vascular territory which is relatively fixed, despite variations from one hemisphere to another or from one brain to another. The limits of these territories are equally precise.

The terms fissure and sulcus as they are classically defined are: a fissure separates one lobe from another, while a sulcus is within a lobe and delimits gyri.

During the development of the embryo, the first vein to appear in the posterior fossa is, according to PADGET (1956), the primitive ventral metencephalic vein since, at this stage, the cerebellar hemisphere is merely represented by a cerebellar plate. This ventral metencephalic vein, homologous to the trigeminal vein of lower vertebrates, will eventually become the petrosal vein. The proximal end of the ventral metencephalic vein becomes incorporated into the petrous crest to form the superior petrosal sinus. The primitive ventral myelencephalic vein, also called the vagal vein (PADGET, 1956), anastomoses superiorly with the ventral metencephalic vein and drains the medulla oblongata. The inferior petrosal sinus is derived from the proximal end of the ventral myelencephalic vein.

The brain is divided into a limited number of lobes by the fissures which penetrate between them; numerous sulci further divide each lobe into convolutions or gyri.

The basal cerebral vein described by ROSENTHAL in 1824 has been the subject of many investigations.

The aqueduct of Sylvius represents the communication between the third and fourth ventricles. It is 15 to 18 mm long and 1 to 2 mm in diameter. Its shape is like the neck of a swan. Posteriorly, its relations are, from superiorly to inferiorly, the posterior commissure, the superior and inferior colliculi and the anterior medullary velum. Its floor is the midbrain, and contains the nuclei of the third and fourth cranial nerves (Fig. 153).

A former study done by one of us (Ph. F.) on angiographic anatomy of the cortical branches of the anterior cerebral artery has shown that some structures of the interhemispheric brain surface can be localized on the lateral angiogram by the arterial loops. In order to advance in this di-rection, the simultaneous study of the frontal incidence with the resulting spatial view of the brain became necessary.

Neuroradiologic progress has unquestionably resulted in an amelioration of neurosurgical techniques. Nevertheless a certain disparity persists between the information furnished by conventional neuroradiology and that which would be most useful at the time of surgery.

The deep cerebral venous system may be said to consists of the two internal cerebral veins and their tributaries—the subependymal, deep medullary, superior striate and choroidal veins. The basal cerebral vein, sometimes included in the deep venous system, is described elsewhere (Part 1, Chap. 4, p. 128).

1. Cerebral Hemisphere.- 1. Fissures and Sulci (G. S.).- I. Anatomic Study of the Fissures and Sulci of the External Surface of the Cerebral Hemisphere.- 1. Principal or Interlobar Fissures.- 2. Sulci of the External Surface.- a) Sulci of the Frontal Lobe.- b) Sulci of the Parietal Lobe.- c) Sulci of the Occipital Lobe.- d) Sulci of the Temporal Lobe.- II. Anatomic Study of the Fissures and Sulci of the Internal Surface of the Cerebral Hemisphere.- 1. Fissures of the Internal Surface.- 2. Sulci of the Internal Surface.- III. Anatomic Study of the Fissures and Sulci of the Inferior Surface of the Cerebral Hemisphere.- 1. Fissure of the Inferior Surface-Sylvian Fissure.- 2. Sulci of the Inferior Surface.- a) Sulci of the Orbital Surface of the Frontal Lobe.- b) Sulci of the Inferior Surface of the Temporal and Occipital Lobes.- IV. Radiologic Study of Fissures and Sulci.- 2. Lateral Ventricles (G. S.).- I. Anatomic Study of the Lateral Ventricles.- 1. Frontal Horn of the Lateral Ventricle.- 2. Body of the Lateral Ventricle.- 3. Atrium of the Lateral Ventricle.- 4. Occipital Horn of the Lateral Ventricle.- 5. Temporal Horn of the Lateral Ventricle.- II. Radiologic Study of the Lateral Ventricles.- 1. Frontal Horn of the Lateral Ventricle.- 2. Body of the Lateral Ventricle.- 3. Atrium of the Lateral Ventricle.- 4. Occipital Horn of the Lateral Ventricle.- 5. Temporal Horn of the Lateral Ventricle.- 3. Cortical Arteries (G. S.).- A. Anterior Cerebral Artery.- I. Anatomic Study of the Anterior Cerebral Artery.- Branches of the Anterior Cerebral Artery.- a) Branch to the Orbital Surface of the Frontal Lobe.- b) Branches to the Internal Surface of the Frontal Lobe.- c) Branch to the Paracentral Lobule.- d) Branches to the Internal Aspect of the Parietal Lobe.- e) Branches to the Corpus Callosum.- II. Radiologic Study of the Anterior Cerebral Artery.- B. Middle Cerebral Artery.- I. Anatomic Study of the Middle Cerebral Artery.- 1. Patterns of Division of the Middle Cerebral Artery within the Sylvian Fissure.- 2. Frontal Branches of the Middle Cerebral Artery.- 3. Parietal Branches of the Middle Cerebral Artery.- 4. Temporal and Temporo-Occipital Branches of the Middle Cerebral Artery.- 5. Insular Branches.- II. Radiologic Study of the Middle Cerebral Artery.- C. Anterior Choroidal Artery.- I. Anatomic Study of the Anterior Choroidal Artery.- II. Radiologic Study of the Anterior Choroidal Artery.- D. Posterior Cerebral Artery.- I. Anatomic Study of the Posterior Cerebral Artery.- II. Radiologic Study of the Posterior Cerebral Artery.- 4. Basal Cerebral Vein (Y. P. H.).- A. Normal Anatomy.- I. First Segment of the Basal Cerebral Vein and Its Tributaries.- 1. Deep Middle Cerebral Vein.- 2. Inferior Striate Veins.- 3. Olfactory Vein.- 4. Fronto-Orbital Veins.- 5. Anterior Cerebral and Pericallosal Veins.- 6. Veinlets from the Optic Chiasm, Optic Tract, and Adjacent Structures.- II. Second Segment of the Basal Cerebral Vein and Its Tributaries>.- 1. Peduncular Vein.- 2. Inferior Ventricular Vein.- III. Third Segment of the Basal Cerebral Vein and Its Tributaries.- 1. Lateral Mesencephalic Vein.- 2. Lateral Atrial Vein.- 3. Medial Temporal and Occipitotemporal Cortical Veins.- 4. Posterior Longitudinal Hippocampal Vein.- 5. Posterior Thalamic Veins.- B. Anatomic Variations.- 2. Mesencephalic Region, Diencephalic Region, and Basal Ganglia.- 1. Third Ventricle and Suprasellar Cisterns (G. S.).- I. Anatomic Study of the Third Ventricle and Suprasellar Cisterns.- 1. Third Ventricle.- 2. Suprasellar Cisterns.- II. Radiologic Study of the Third Ventricle and Suprasellar Cisterns.- 2. Aqueduct of Sylvius (G. S.).- I. Anatomic Study of the Aqueduct of Sylvius.- II. Radiologic Study of the Aqueduct of Sylvius.- 3. Arteries of the Basal Ganglia and the Posterior Choroidal Arteries (G. S.).- I. Anatomic Study of the Perforating Arteries of the Basal Ganglia and of the Posterior Choroidal Arteries.- 1. Perforating Branches of the Carotid System.- a) Perforating Branches of the Anterior Cerebral Artery.- b) Perforating Branches of the Middle Cerebral Artery.- c) Perforating Branches of the Anterior Choroidal Artery.- 2. Perforating Branches of the Vertebrobasilar System.- a) Arteries to the Inferior Surface of the Thalamus.- b) Arteries to the Posterior Surface of the Thalamus.- c) Arteries to the Superior Surface of the Thalamus.- II. Radiologic Study of the Perforating Arteries of the Basal Ganglia and of the Posterior Choroidal Arteries.- 4. Deep Cerebral Veins (Y. P. H.).- A. Internal Cerebral and Great Cerebral Veins.- B. Subependymal Veins of the Lateral Ventricle.- I. Medial Group of theSubependymal Veins.- 1. Septal Vein.- 2. Posterior Septal Vein.- 3. Medial Atrial Vein.- 4. Transverse Hippocampal Subependymal Veins.- II. Lateral Group of the Subependymal Veins.- 1. Thalamostriate Vein.- 2. Direct Lateral Vein.- 3. Inferior Ventricular Vein.- C. Choroidal Veins of the Lateral Ventricle.- D. Veins of the White Matter of the Cerebral Hemisphere-Medullary Veins.- E. Veins of the Grey Matter of the Cerebral Hemisphere.- 3. Posterior Fossa.- 1. Fourth Ventricle and Cisterns of the Posterior Fossa (G. S.).- I. Anatomic Study of the Fourth Ventricle.- 1. Floor of the Fourth Ventricle.- 2. Roof of the Fourth Ventricle t2.- II. Anatomic Study of the Posterior Fossa Cisterns.- 1. Cisterns Anterior to the Brainstem.- a) Medullary Cistern.- b) Pontine Cistern.- c) Cerebellopontine Angle Cistern.- 2. Cistern Posterior to the Medulla and Below the Inferior Vermis-Cisterna Magna.- 3. Cisterns Posterior to the Tectum and Superior to the Cerebellum.- 4. Cisterns Around the Cerebral Peduncles.- III. Radiologic Study of Posterior Fossa, Fourth Ventricle and Cisterns of the Posterior Fossa.- 2. Arteries of the Vertebrobasilar System (G. S.).- I. Anatomic Study of the Arteries of the Vertebrobasilar System.- 1. Intracranial Segment of the Vertebral Artery.- 2. Basilar Trunk.- 3. Arteries of the Brainstem.- a) Arteries of the Medulla.- b) Arteries of the Pons.- c) Arteries of the Cerebral Peduncles.- 4. Arteries of the Cerebellum.- a) Superior Cerebellar Artery-SCA.- b) Anterior Inferior Cerebellar Artery-AICA.- c) Posterior Inferior Cerebellar Artery-PICA.- II. Radiologic Study of the Arteries of the Vertebrobasilar System.- 1. Basilar Trunk and Its Branches.- 2. Anterior. Inferior Cerebellar Artery-AICA.- 3. Superior Cerebellar Artery-SCA.- 3. Veins of the Posterior Fossa (Y. P. H.).- I. Superior or Galenic Draining Group.- 1. Mesencephalic Tributaries.- 2. Cerebellar Tributaries.- II. Anterior or Petrosal Draining Group.- 1. Tributaries Related to the Anterior Aspect of the Brain Stem.- 2. Tributaries Related to the Wing of the Precentral Cerebellar Fissure.- 3. Tributaries Related to the Posterolateral Fissure.- 4. Tributaries Related to the Cerebellomedullary Fissure.- 5. Tributaries Related to the Cerebellar Hemisphere.- III. Posterior or Tentorial Draining Group.- IV. Intercommunications Among the Superior, Anterior and Posterior Draining Groups and Between the Supra- and Infratentorial Veins.- V. Circulation Times of Veins of the Posterior Fossa.- References.

Knowledge of the radiologic anatomy of the posterior fossa has certainly benefited from recent investigations into the arterial supply and venous drainage of its structures, and from studies of the anatomy of the fourth ventricle and cisterns of the posterior fossa.

The vascularization of the lentiform nucleus, the caudate nucleus, the thalamus and the internal capsule is provided by perforating arteries which arise from the anterior, middle and posterior cerebral arteries and the anterior choroidal arteries. The carotid branches supply the nuclei of telencephalic origin (caudate and lentiform) while the vertebrobasilar branches supply the diecephalic nuclei (thalamus).