Vessel
Middle cerebral artery
A major arterial tree for the lateral hemisphere
High-yield
MCA ischemia often affects the opposite face and arm more than the leg. Language disturbance may accompany dominant-hemisphere injury; spatial neglect is especially associated with right-hemisphere network injury. None is obligatory after every branch occlusion.
Overview
The MCA leaves the internal carotid and travels laterally toward the insula. Small perforators enter the basal forebrain, while larger branches spread across insular, opercular and lateral cortical surfaces. The familiar superior and inferior divisions are common, but trifurcation and other branching patterns occur. Its deep and cortical territories have different clinical implications.
Reference facts
- Origin
- A large terminal branch of the internal carotid; it extends laterally away from the connecting circle of Willis.
- Course
- Conventionally M1 is sphenoidal/horizontal, M2 insular, M3 opercular and M4 cortical. Segment boundaries and the main bifurcation need not coincide exactly.
- Branches
- Lenticulostriate perforators and variable early cortical branches, followed by larger cortical trunks commonly organized into superior and inferior divisions.
- Supplies
- Much lateral frontal, parietal and temporal cortex, including major face/upper-limb sensorimotor and language-related regions. Perforators reach basal ganglia and capsular territories.
Clinical correlation
In the dominant hemisphere, superior-division injury often impairs speech production and face/arm movement, whereas inferior-division injury may affect comprehension and visual fields. These are broad vascular patterns within language networks. A small deep motor-pathway infarct can instead lack obvious cortical signs.
Frequently asked questions
Where does the middle cerebral artery originate?
A large terminal branch of the internal carotid; it extends laterally away from the connecting circle of Willis.
What does the middle cerebral artery supply?
Much lateral frontal, parietal and temporal cortex, including major face/upper-limb sensorimotor and language-related regions. Perforators reach basal ganglia and capsular territories.
What are the branches of the middle cerebral artery?
Lenticulostriate perforators and variable early cortical branches, followed by larger cortical trunks commonly organized into superior and inferior divisions.
What is the course of the middle cerebral artery?
Conventionally M1 is sphenoidal/horizontal, M2 insular, M3 opercular and M4 cortical. Segment boundaries and the main bifurcation need not coincide exactly.