The middle cerebral artery is a terminal branch of the internal carotid artery, and is one of the three main vessels that supply the brain with arterial blood.
Anatomy
The middle cerebral artery is microsurgically divided into four segments[^1] :
Segments
Anatomy
Branches
Sphenoidal segment (M1)
The M1 segment runs from the beginning of the MCA laterally to the genu, where the MCA runs in a 90° loop. The M1 segment is divided into a pre-bifurcation segment and a post-bifurcation segment. In 86 % of the cerebral hemispheres, the bifurcation is proximal to the genu of the MCA.
Small cortical arterial branches: “early branches”
Insular segment (M2)
The M2 segment of the MCA runs from the genu to the circular sulcus.
Multiple branches, mainly on the anterior part of the insula.
Opercular segment (M3)
The M3 segment of the MCA runs from the circular sulcus to the surface of the sylvian fissure.
Multiple branches.
Cortical segment (M4)
The branches of the M4 segment of the MCA run from the surface of the sylvian fissure and spread over the cortex of the hemispheres.
Multiple branches.
Imaging
Visualization of the four segments of the middle cerebral artery (MCA) in a digital subtraction angiography.
MCA segments on a DSA
Visualization of the four segments of the middle cerebral artery (MCA) in a digital subtraction angiography.