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Biomedical Reviews

Pathways and nerve densities in cerebrovascular innervation

Ronald L. A. W. Bleys, Gerbrand J. Groen


It is gradually becoming clear that cerebrovascular nerves contribute to the control of the cerebral circulation although the knowledge of the functional mechanisms is far from complete. However, many aspects of the morphologic substrate have been identified. The basal cerebral arteries receive sympathetic, parasympathetic and sensory innervation, utilizing the superior cervical and stellate, the pterygopalatine and otic, and the trigeminal ganglia, respectively, as the main peripheral sources. Many of the neural pathways to the cerebral arteries have been elucidated. Those to the supratentorial arterial tree are distributed via the cavernous sinus and surrounding regions. Not only the "classical" neurotransmitters, but also many neuropeptides are found in cerebrovascular nerves. This will lead to new insights since the concepts of cotransmission and neuromodulation have been established now. In the arterial wall, a multilayered organization of nerves has been recognized, consisting of paravascular nerve bundles of passage, a superficial plexus and a terminal plexus located at the adventitial-medial border. Human basal cerebral arteries display a topographical heterogeneity of densities of terminal nerve plexuses. Highest nerve densities are found in arterial segments forming the circle of Willis, in the efferent part of the posterior cerebral artery and in the anterior choroidal artery. Nerve density appears to be determined by locality rather than vascular diameter. Furthermore, local decreases in nerve density are observed with ageing and disease in animals and humans.

Biomedical Reviews 1995; 4: 35-46.

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About The Authors

Ronald L. A. W. Bleys
Utrecht University

Gerbrand J. Groen
Utrecht University

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