Would a blood clot lodged in one of the anterior or posterior communicating arte

Question

Would a blood clot lodged in one of the anterior or posterior communicating arteries of the cerebral arterial circle be likely to cause significant deficits in blood flow to the brain? Why or why not? 1 2 Your patient presents with severe abdominal pain. Your team orders a CT scan and discovers a large blood clot lodged in the celiac trunk. What organs could this blood clot potentially affect? Why do you think the clot is causing abdominal pain? 3 Certain drugs cannot be taken by mouth because the entire dose of the drug is destroyed in the liver before it ever reaches the general circulation. Explain why these same drugs can be given by injection, either intravenously or intramuscularly. (Hint:Consider the hepatic portal system.)

Explanation / Answer

Ans.1) No there will be no significant deficits in the blood flow to the brain.

The posterior communicating artery joins the posterior cerebral artery and the internal carotid artery. The anterior communicating artery joins the anterior cerebral arteries of the two hemispheres together. The middle cerebral arteries are connected to the posterior communicating arteries (forming Circle of Willis). This anastomosis between the arteries is responsible for developing Collateral circulation. It provides a safety mechanism, if one of the major vessels becomes occluded within the circle or proximal to it, the circle will still provide the brain with continued supply of blood. Thus preventing any significant deficit in blood flow to the brain and preventing the neurological damage.

2. The celiac trunk provides oxygenated blood to the stomach, liver, spleen and the part of oesophagus that reaches into the abdomen. It also supplies the upper half of duodenum and the pancreas. The celaic trunk is a critical blood source for the gut therefore any obstruction of the celiac artery is extremely dangerous for these organs.

The pain associated with obstruction of these major arteries is due to organ ischemia or lack of oxygenated blood to these organs.

3. The drugs given intravenously or intramuscularly reaches the tissues by capillary beds before it get destroyed in the hepatic portal system. Drugs administered via Parenteral route enter directly into the systemic circulation and have direct access to the rest of the body.

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