Middle cerebral artery

Changed by Craig Hacking, 5 Aug 2015

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The middle cerebral artery (MCA) is one of the three major paired arteries that supply blood to the brain. The MCA arises from the internal carotid artery (ICA) as the larger of the two main terminal branches (MCA and anterior cerebral artery) ~~and continues~~coursing laterally into the lateral sulcus where it branches and provides many branches that supply the cerebral cortex.

Gross anatomy

Segments

The MCA is divided into four segments:

M1: from the origin to bifurcation/trifurcation (the limen insulae); also known as horizontal or sphenoidal segment
M2: also known as insular segment, from bi(tri)furcation to circular sulcus of insula where it makes hairpin bend to continue as M3
M3: opercular branches (those within the Sylvian fissure); also known as opercular segment
M4: branches emerging from the Sylvian fissure onto the convex surface of the hemisphere; also known as cortical segment

Branches

M1

medial lenticulostriate penetrating arteries
lateral lenticulostriate penetrating arteries
anterior temporal artery
polar temporal artery
uncal artery ~~(with branches also~~(which may branch from the anterior choroidal artery)

M2

Division of the MCA is variable after the horizontal segment, although most commonly, it divides into two trunks-superior and inferior:

78% bifurcate into superior and inferior divisions
12% trifucate into superior, middle and inferior divisions
10% branch into many smaller branches

Superior terminal branch

lateral frontobasal artery
prefrontal sulcal artery
pre-Rolandic (precentral) and Rolandic (central) sulcal arteries

Inferior terminal branch

three temporal branches (anterior, middle, posterior)
branch to the angular gyrus
two parietal branches (anterior, posterior)

Supply

The middle cerebral arteries supply the majority of the lateral surface of the hemisphere, except the superior portion of the parietal lobe (via ACA) and the inferior portion of the temporal lobe and occipital lobe (via PCA). In addition, they supply part of the internal capsule and basal ganglia.

In its territory lie the motor and sensory areas excluding leg and perineum and auditory and speech areas.

Variant anatomy

MCA duplication-reported incidence of ~1.5% (range 0.2-2.9%); parallels the main MCA and supplies the anterior lobe
accessory MCA
MCA fenestration is rare with a report incidence of <1%
early branching of the MCA-bi/trifurcation occurs within 1 cm of origin

-<p>The <strong>middle cerebral artery</strong> (<strong>MCA</strong>) is one of the three major paired arteries that supply blood to the brain. The MCA arises from the <a href="/articles/internal-carotid-artery-1">internal carotid artery</a> (ICA) as the larger of the two main terminal branches (MCA and <a href="/articles/anterior-cerebral-artery">anterior cerebral artery</a>) and continues into the <a href="/articles/lateral-sulcus">lateral sulcus</a> where it branches and provides many branches that supply the cerebral cortex.</p><h4>Gross anatomy</h4><h5>Segments</h5><p>The MCA is divided into four segments:</p><ul>
+<p>The <strong>middle cerebral artery</strong> (<strong>MCA</strong>) is one of the three major paired arteries that supply blood to the brain. The MCA arises from the <a href="/articles/internal-carotid-artery-1">internal carotid artery</a> (ICA) as the larger of the two main terminal branches (MCA and <a href="/articles/anterior-cerebral-artery">anterior cerebral artery</a>) coursing laterally into the <a href="/articles/lateral-sulcus">lateral sulcus</a> where it branches and provides many branches that supply the cerebral cortex.</p><h4>Gross anatomy</h4><h5>Segments</h5><p>The MCA is divided into four segments:</p><ul>
~~-<a href="/articles/uncal-artery">uncal artery</a> (with branches also from the anterior choroidal artery)</li>~~
+<a href="/articles/uncal-artery">uncal artery</a> (which may branch from the anterior choroidal artery)</li>

References changed:

1. Louis R. Caplan, Jan van Gijn. Stroke Syndromes, 3ed. (2012) ISBN: 9781107018860 - <a href="http://books.google.com/books?vid=ISBN9781107018860">Google Books</a>
3. Duane E. Haines. Neuroanatomy. (2008) ISBN: 9780781763288 - <a href="http://books.google.com/books?vid=ISBN9780781763288">Google Books</a>
2. Hans-Joachim Kretschmann, Wolfgang Weinrich. Cranial Neuroimaging and Clinical Neuroanatomy. (2004) ISBN: 9781588901453 - <a href="http://books.google.com/books?vid=ISBN9781588901453">Google Books</a>
Caplan LR, van Gijn J. Stroke Syndromes, 3ed. Cambridge University Press. (2012) ISBN:1107018862. <a href="http://books.google.com/books?vid=ISBN1107018862">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1107018862">Find it at Amazon</a><span class="ref_v3"></span>
Haines DE. Neuroanatomy. Lippincott Williams & Wilkins. (2008) ISBN:0781763282. <a href="http://books.google.com/books?vid=ISBN0781763282">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0781763282">Find it at Amazon</a><span class="ref_v3"></span>
Kretschmann H, Weinrich W. Cranial Neuroimaging and Clinical Neuroanatomy. Thieme. (2004) ISBN:1588901459. <a href="http://books.google.com/books?vid=ISBN1588901459">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1588901459">Find it at Amazon</a><span class="ref_v3"></span>

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