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Arterial Supply of the Central Core

Surgical Correlation

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Arterial Supply of the Central Core. A, All cerebral lobes were removed and the central core is seen on top of the brainstem in a lateral view. The middle cerebral artery (MCA) arises from the internal carotid artery (ICA), and first passes below the central core (M1 segment) and later bends over the insular surface (M2 segment). Small arterial branches arise from the M2 segment of the MCA and supply the most lateral structures of the central core (insular surface, extreme capsule, claustrum, and external capsule). B, The left central core was removed and the arteries related to its vascularization can be seen. The lenticulostriate arteries arise from the M1 segment of the MCA, and the thalamoperforating arteries arise from the basilar tip and proximal segments of the posterior cerebral artery (PCA). The lateral and medial posterior choroidal arteries also arise from the proximal segments of the PCA; the first will enter the lateral ventricle, and the second will continue encircling the central core posteriorly and superiorly to supply these regions. C, In this enlarged and inferior view of the central core, note the anterior perforated substance being perforated by several small lenticulostriate arteries arising from the ICA bifurcation and the proximal segments of anterior choroidal artery (ACA) and MCA; meanwhile, the posterior perforated substance is penetrated by the thalamoperforating arteries. D, In this lateral view of the central core, the insular surface, extreme capsule, claustrum, and external capsule were removed. Note the lenticulostriate arteries’ trajectory through the anterior perforated substance toward the lentiform nucleus. E, The lenticulostriate arteries form 2 peduncles in relation to the anterior commissure: the anterior peduncle will continue toward the putamen, while the posterior peduncle will continue toward the globus pallidus. F, The central core is seen from above, with the caudate nucleus being detached from the internal capsule. The lenticulostriate arteries, after supplying the internal capsule, continue medially toward the caudate nucleus. (Images courtesy of E de Oliveira)

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