Question 5
Part A. In which of the following regions do both hypertensive intracerebral hemorrhages and lacunar infarcts commonly occur? Indicate ALL correct answers.
a. Basal ganglia
b. Primary Visual cortex
c. Thalamus
d. Pons
e. Wernicke's area
Part B. What feature is shared by the blood vessels that supply the areas you indicated in Part A?
a. All originate as branches of the carotid system
b. All originate as branches of the vertebral-basilar system
c. All are long slender branches of much larger vessels that penetrate deeply into the brain without anastomosing
d. All are short vessels that form multiple branches which anastomose with each other
Answer to Question 5
Part A. Correct Answer:
a. Basal ganglia 
c. Thalamus 
d. Pons 
Part B. Correct Answer:
c. All are long slender branches of much larger vessels that penetrate deeply into the brain without anastomosing
Additional Information
Arteries supplying all three areas (basal ganglia, thalamus, pons) are susceptible to small vessel disease. In individuals with untreated hypertension, both hemorrhages and small (lacunar) ischemic strokes tend to involve these areas, as well as the internal capsule and cerebellum. This may be partially explained by the observation that arteries supplying all these areas share certain anatomic features:
- they form at near right angles from large arterial stems where blood pressure is high
- they have small diameters they penetrate for long distances into brain tissue
- they form few anastomoses with neighboring vessels.
For more information: Clinical Note 1 | Clinical Note 2 | Clinical Note 3