Middle Cerebral Artery, Gross Anatomy

Description

Arising from the internal carotid artery, the middle cerebral artery (MCA) courses laterally into the Sylvian fissure, then divides into M2 insular and more distal M3 opercular segments that spread over the lateral convexity of the cerebral hemisphere. Numerous lenticulostriate arteries branch superiorly and medially from the proximal MCA and penetrate the anterior perforated substance to supply the basal ganglia and internal capsule. Superficial MCA cortical branches run within the sulci over the frontal, parietal, and temporal lobes, while venous drainage on the convexity converges toward the superior sagittal sinus along the midline. Cranial nerves at the base provide additional orientation to the circle of Willis region. For stroke teaching, few territories are requested more often than the MCA. Occlusion proximal to the lenticulostriate origins can combine cortical deficits with deep perforator infarction, a pattern that maps cleanly onto contralateral face and arm weakness, aphasia in the dominant hemisphere, or hemispatial neglect in the nondominant hemisphere. Those lenticulostriate branches are also common sites of Charcot-Bouchard microaneurysms in chronic hypertension, explaining classic intracerebral hemorrhage into the putamen with abrupt internal capsule involvement. Small vessels. Big consequences. Use this artwork for neuroanatomy and cerebrovascular modules, neuroradiology correlation plates (angiography and CTA/MRA territory mapping), and neurosurgical teaching on Sylvian fissure splitting and MCA aneurysm approaches where M1, M2, and perforator preservation drive the operative plan. Anatomical accuracy verified by SciePro's Medical Advisory Board.