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middle cerebral artery anatomy
The MCA is the largest and most complex of the cerebral arteries. It arises from the internal carotid artery and has four segments - M1, M2, M3, M4. The M1 segment can be further divided into pre-bifurcation and post-bifurcation parts. Early branches and perforating arteries originate from the M1 segment. The MCA has a variable branching pattern and anomalies include duplication, accessory branches, and fenestration. Key angiographic landmarks include the Sylvian point and Sylvian triangle.
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middle cerebral artery anatomy
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- 2. Introduction • The MCAis the largest and most complex of the cerebral arteries • The MCA arises as the larger of the two terminal branches of the internal carotid artery • The diameter of the MCA at its origin ranges (average, 3.9 mm), roughly twice that of the anterior cerebral artery
- 3. Its origin andcourse
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- 7. Segments •M1 (sphenoidal), •M2 (insular), •M3(opercular), •M4 (cortical)
- 10. M1 segment • Microneurosurgicaland angiographic • Prebifurcation and post bifurcation parts • How to distinguish between early branches and M1
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- 12. Early branches • CorticalBranches from main trunk proximal to MCA division • types • early temporal branches- more common • early frontal branches
- 18. Perforating branches • Lenticulostraitearteries - branches of MCA that enter anterior perforating substance (APS) • origin from superior or posterosuperior MCA • 3 groups : medial, intermediate and lateral • MEDIAL: least constant, 1-5 branches from M1, enter medial APS • INTERMEDIATE: constant, few branches dividing, atleast 1 major artery • LATERAL: constant S shaped course, enter posterolateral part of APS
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- 28. Anomalies of MCA •Rare compared to other intracranial arteries Main anomalies include • duplication • accessory • fenestration
- 30. Anatomy of theMiddle Cerebral Artery: Cortical Branches, Branching Pattern and Anomalies; Karen CILLIERS, Benedict John PAGE; DOI: 10.5137/1019-5149.JTN.18127-16.1
- 31. Angiographic Sylvian Point(ASP) • It is the most medial point where the last cortical MCA branch (usually the angular artery) turns inferiorly to exit the sylvian fissure.(On AP view) • This point approximates the apex of the insula and represents the posterior limit of the lateral cerebral sulcus.
- 33. Sylvian triangle (angiographic) •The superior insular line ( A line tangent to the tops of the insular loops), • Main MCA trunk ( forms the posterior inferior margin of the triangle) • Most anterior branch of the ascending frontal complex ( forms the anterior border of the triangle) • It is seen in lateral view and serves as angiographic landmark for localizing supratentorial masses.
- 36. • Round shift= Frontal lesion anterior to coronal suture • Square shift = Lesion behind foramen of Monro in lower half of hemisphere • Distal shift = Posterior to coronal suture in upper half of hemisphere • Proximal shift = Basifrontal lesion / anterior middle cranial fossa including anterior temporal lobe
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Editor's Notes
- #4 at the medial end of the sylvian fissure, lateral to the optic chiasm, below the anterior perforated substance, and posterior to the division of the olfactory tract into the medial and lateral olfactory striae