Middle cerebral artery

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Middle cerebral artery
Gray's Anatomy plate 517 brain.png
Outer surface of cerebral hemisphere, showing areas supplied by cerebral arteries (Pink is region supplied by middle cerebral artery.)
Circle of Willis en.svg
The arterial circle and arteries of the brain (inferior view). The middle cerebral arteries (top of figure) arise from the internal carotid arteries.
Details
Source Internal carotid arteries
Branches Anterolateral central arteries
Vein Middle cerebral vein
Supplies Cerebrum
Identifiers
Latin arteria cerebri media
MeSH D020768
TA98 A12.2.07.046
TA2 4509
FMA 50079
Anatomical terminology

The middle cerebral artery (MCA) is one of the three major paired cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches and projects to many parts of the lateral cerebral cortex. It also supplies blood to the anterior temporal lobes and the insular cortices.

Contents

The left and right MCAs rise from trifurcations of the internal carotid arteries and thus are connected to the anterior cerebral arteries and the posterior communicating arteries, which connect to the posterior cerebral arteries. The MCAs are not considered a part of the Circle of Willis. [1]

Structure

Middle cerebral artery Circle of Willis 6.jpg
Middle cerebral artery
Middle cerebral artery and its branches (patient has a hypoplastic A1 segment and an absent PCOM, resulting in a purely MCA angio from internal carotid artery injection) MCA angio lateral.jpg
Middle cerebral artery and its branches (patient has a hypoplastic A1 segment and an absent PCOM, resulting in a purely MCA angio from internal carotid artery injection)

The middle cerebral artery divides into four segments, named by the region they supply as opposed to order of branching as the latter can be somewhat variable: [2]

The M2 and M3 segments may each split into 2 or 3 main trunks (terminal branches) with an upper trunk, lower trunk and occasionally a middle trunk. Bifurcations and trifurcations occurs in 50% and 25% of the cases respectively. Other cases include duplication of the MCA at the internal carotid artery (ICA) or an accessory MCA (AccMCA) which arise not from the ICA but as a branch from the anterior cerebral artery. [4] The middle trunk that exist in parts of the population, when present provides the pre-Rolandic, Rolandic, anterior parietal, posterior parietal and the angular artery for irrigation instead of the upper and lower trunks.

The branches of the MCA can be described by the areas that they irrigate.

Frontal lobe

Parietal lobe

Temporal lobe

Function

Areas supplied by the middle cerebral artery include:

MCA occlusion site and resulting Aphasia

Clinical significance

Occlusion

Occlusion of the middle cerebral artery results in Middle cerebral artery syndrome, potentially showing the following defects:

  1. Paralysis (-plegia) or weakness (-paresis) of the contralateral face and arm (faciobrachial)
  2. Sensory loss of the contralateral face and arm.
  3. Damage to the dominant hemisphere (usually the left hemisphere) results in aphasia (i.e. Broca's area or Wernicke's)
  4. Damage to the non-dominant hemisphere (usually the right hemisphere) results in contralateral neglect syndrome, inaccurate localization in the half field, impaired ability to judge distance (nondominant parietal lobe).
  5. Large MCA infarcts often have déviation conjuguée, a gaze preference towards the side of the lesion, especially during the acute period. Contralateral homonymous hemianopsia is often present.

See also

Related Research Articles

Articles related to anatomy include:

<span class="mw-page-title-main">Brodmann area</span> Region of the brain

A Brodmann area is a region of the cerebral cortex, in the human or other primate brain, defined by its cytoarchitecture, or histological structure and organization of cells. The concept was first introduced by the German anatomist Korbinian Brodmann in the early 20th century. Brodmann mapped the human brain based on the varied cellular structure across the cortex and identified 52 distinct regions, which he numbered 1 to 52. These regions, or Brodmann areas, correspond with diverse functions including sensation, motor control, and cognition.

<span class="mw-page-title-main">Parietal lobe</span> Part of the brain responsible for sensory input and some language processing

The parietal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The parietal lobe is positioned above the temporal lobe and behind the frontal lobe and central sulcus.

<span class="mw-page-title-main">Frontal lobe</span> Part of the brain

The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere. It is parted from the parietal lobe by a groove between tissues called the central sulcus and from the temporal lobe by a deeper groove called the lateral sulcus. The most anterior rounded part of the frontal lobe is known as the frontal pole, one of the three poles of the cerebrum.

<span class="mw-page-title-main">Brodmann area 40</span> Part of the parietal cortex in the human brain

Brodmann area 40 (BA40) is part of the parietal cortex in the human brain. The inferior part of BA40 is in the area of the supramarginal gyrus, which lies at the posterior end of the lateral fissure, in the inferior lateral part of the parietal lobe.

<span class="mw-page-title-main">Internal capsule</span> White matter structure situated in the inferomedial part of each cerebral hemisphere of the brain

The internal capsule is a white matter structure situated in the inferomedial part of each cerebral hemisphere of the brain. It carries information past the basal ganglia, separating the caudate nucleus and the thalamus from the putamen and the globus pallidus. The internal capsule contains both ascending and descending axons, going to and coming from the cerebral cortex. It also separates the caudate nucleus and the putamen in the dorsal striatum, a brain region involved in motor and reward pathways.

<span class="mw-page-title-main">Lateral sulcus</span> Crevice in the brain separating the frontal and parietal lobes from the temporal

In neuroanatomy, the lateral sulcus is one of the most prominent features of the human brain. The lateral sulcus is a deep fissure in each hemisphere that separates the frontal and parietal lobes from the temporal lobe. The insular cortex lies deep within the lateral sulcus.

<span class="mw-page-title-main">Inferior frontal gyrus</span> Part of the brains prefrontal cortex

The inferior frontal gyrus (IFG),, is the lowest positioned gyrus of the frontal gyri, of the frontal lobe, and is part of the prefrontal cortex.

<span class="mw-page-title-main">Precentral gyrus</span> Motor gyrus of the posterior frontal lobe of the brain

The precentral gyrus is a prominent gyrus on the surface of the posterior frontal lobe of the brain. It is the site of the primary motor cortex that in humans is cytoarchitecturally defined as Brodmann area 4.

<span class="mw-page-title-main">Anterior cerebral artery</span> Artery supplying the brain

The anterior cerebral artery (ACA) is one of a pair of cerebral arteries that supplies oxygenated blood to most midline portions of the frontal lobes and superior medial parietal lobes of the brain. The two anterior cerebral arteries arise from the internal carotid artery and are part of the circle of Willis. The left and right anterior cerebral arteries are connected by the anterior communicating artery.

<span class="mw-page-title-main">Sulcus (morphology)</span> Groove in an organ surface

In biological morphology and anatomy, a sulcus is a furrow or fissure. It may be a groove, natural division, deep furrow, elongated cleft, or tear in the surface of a limb or an organ, most notably on the surface of the brain, but also in the lungs, certain muscles, as well as in bones, and elsewhere. Many sulci are the product of a surface fold or junction, such as in the gums, where they fold around the neck of the tooth.

<span class="mw-page-title-main">Lobes of the brain</span> Parts of the cerebrum

The lobes of the brain are the major identifiable zones of the human cerebral cortex, and they comprise the surface of each hemisphere of the cerebrum. The two hemispheres are roughly symmetrical in structure, and are connected by the corpus callosum. They traditionally have been divided into four lobes, but are today considered as having six lobes each. The lobes are large areas that are anatomically distinguishable, and are also functionally distinct to some degree. Each lobe of the brain has numerous ridges, or gyri, and furrows, the sulci that constitute further subzones of the cortex. The expression "lobes of the brain" usually refers only to those of the cerebrum, not to the distinct areas of the cerebellum.

<span class="mw-page-title-main">Posterior cerebral artery</span> Artery which supplies blood to the occipital lobe of the brain

The posterior cerebral artery (PCA) is one of a pair of cerebral arteries that supply oxygenated blood to the occipital lobe, part of the back of the human brain. The two arteries originate from the distal end of the basilar artery, where it bifurcates into the left and right posterior cerebral arteries. These anastomose with the middle cerebral arteries and internal carotid arteries via the posterior communicating arteries.

<span class="mw-page-title-main">Cerebral arteries</span> 3 main pairs of arteries which supply blood to the cerebrum of the brain

The cerebral arteries describe three main pairs of arteries and their branches, which perfuse the cerebrum of the brain. The three main arteries are the:

<span class="mw-page-title-main">Inferior parietal lobule</span> Portion of the parietal lobe of the brain

The inferior parietal lobule lies below the horizontal portion of the intraparietal sulcus, and behind the lower part of the postcentral sulcus. Also known as Geschwind's territory after Norman Geschwind, an American neurologist, who in the early 1960s recognised its importance. It is a part of the parietal lobe.

<span class="mw-page-title-main">Foix–Chavany–Marie syndrome</span> Medical condition

Foix–Chavany–Marie syndrome (FCMS), also known as bilateral opercular syndrome, is a neuropathological disorder characterized by paralysis of the facial, tongue, pharynx, and masticatory muscles of the mouth that aid in chewing. The disorder is primarily caused by thrombotic and embolic strokes, which cause a deficiency of oxygen in the brain. As a result, bilateral lesions may form in the junctions between the frontal lobe and temporal lobe, the parietal lobe and cortical lobe, or the subcortical region of the brain. FCMS may also arise from defects existing at birth that may be inherited or nonhereditary. Symptoms of FCMS can be present in a person of any age and it is diagnosed using automatic-voluntary dissociation assessment, psycholinguistic testing, neuropsychological testing, and brain scanning. Treatment for FCMS depends on the onset, as well as on the severity of symptoms, and it involves a multidisciplinary approach.

The sensory cortex can refer informally to the primary somatosensory cortex, or it can be used as a term for the primary and secondary cortices of the different senses : the visual cortex on the occipital lobes, the auditory cortex on the temporal lobes, the primary olfactory cortex on the uncus of the piriform region of the temporal lobes, the gustatory cortex on the insular lobe, and the primary somatosensory cortex on the anterior parietal lobes. Just posterior to the primary somatosensory cortex lies the somatosensory association cortex, which integrates sensory information from the primary somatosensory cortex to construct an understanding of the object being felt. Inferior to the frontal lobes are found the olfactory bulbs, which receive sensory input from the olfactory nerves and route those signals throughout the brain. Not all olfactory information is routed to the olfactory cortex: some neural fibers are routed to the supraorbital region of the frontal lobe, while others are routed directly to limbic structures. The direct limbic connection makes the olfactory sense unique.

<span class="mw-page-title-main">Superior longitudinal fasciculus</span> Association fiber tract of the brain

The superior longitudinal fasciculus (SLF) is an association tract in the brain that is composed of three separate components. It is present in both hemispheres and can be found lateral to the centrum semiovale and connects the frontal, occipital, parietal, and temporal lobes. This bundle of tracts (fasciculus) passes from the frontal lobe through the operculum to the posterior end of the lateral sulcus where they either radiate to and synapse on neurons in the occipital lobe, or turn downward and forward around the putamen and then radiate to and synapse on neurons in anterior portions of the temporal lobe.

The cistern of lateral cerebral fossa is an elongated subarachnoid cistern formed by arachnoid mater bridging the lateral sulcus between the frontal, temporal, and parietal opercula. The cistern contains the middle cerebral artery (MCA) and its branches, and the two middle cerebral veins (MCVs).

References

  1. Moore KL, Dalley AR. Clinically Oriented Anatomy, 4th Ed., Lippincott Williams & Wilkins, Toronto. Copyright 1999. ISBN   0-683-06141-0.
  2. Krayenbühl, Hugo; Yaşargil, Mahmut Gazi; Huber, Peter; Bosse, George (1982), Cerebral Angiography, Thieme, pp. 105–123, ISBN   978-0-86577-067-6
  3. "Middle Cerebral Artery".
  4. Osborn, Anne G.; Jacobs, John M. (1999), Diagnostic Cerebral Angiography, Lippincott Williams & Wilkins, pp. 143–144, ISBN   978-0-397-58404-8