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Intracranial arteries are the arterial vessels within the skull that deliver oxygenated blood to the brain, primarily comprising segments of the internal carotid arteries (ICA, C1-C7), vertebral arteries (V4 intracranial), basilar artery, and their branches like the middle cerebral artery (MCA M1-M4), anterior cerebral artery (ACA A1-A5), and posterior cerebral artery (PCA P1-P5). These arteries form the circle of Willis at the brain base, providing collateral circulation, with key branches supplying regions such as the basal ganglia (lenticulostriate arteries), internal capsule (anterior choroidal artery), and cortex (cortical segments). Structurally, intracranial arteries differ from extracranial ones with thinner media, fewer elastic fibers, absent external elastic lamina, and rare vasa vasorum, making them more muscular and prone to specific pathologies. In disease, they play central roles in ischemic stroke via medium/large vessel occlusion (e.g., MCA M3/M4), aneurysms (e.g., PComA), and atherosclerosis (e.g., ICA V4), with variants like vertebral hypoplasia increasing infarct risk. They are not molecular therapeutic targets like receptors or enzymes; interventions focus on mechanical thrombectomy, stenting, or antiplatelets rather than direct pharmacologic modulation of the vessel itself.
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