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The Middle Cerebral Artery and Regional Anatomy

Surgical Correlation

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The Middle Cerebral Artery and Regional Anatomy. A, Basal view of the cerebrum. 1, anterior orbital gyrus; 2, olfactory tract; 3, lateral orbital gyrus; 4, medial orbital gyrus; 5, rectus gyrus; 6, insula; 7, anterior perforated substance; 8, insular pole; 9, amygdala; 10, carotid bifurcation, oculomotor nerve, and the optic tract; 11, head of the hippocampus. The arrowheads indicate the extent of M1 segment. B, Superior view. 1, orbit; 2, genu of the MCA; 3, planum polare; 4, olfactory tract and optic nerve; 5, anterior cerebral artery; 6, insular pole; 7, anteromedial surface of the uncus; 8, posterior communicating artery; 9, head of the hippocampus; 10, posteromedial surface of the uncus, anterior choroidal artery, and P2A segment of the posterior cerebral artery; 11, medial end of the Heschl’s gyrus and the sylvian point; 12, midbrain; 13, atrium. M1, M2, M3, M4, segments of the MCA. C, Lateral view of the left insula and M2 segment of the MCA. 1, corpus callosum; 2, superior limiting sulcus of insula; 3, anterior limiting sulcus of insula; 4, inferior limiting sulcus of the insula; 5, straight sinus; 6, orbit; 7, tentorial edge and middle fossa. D, Anteroposterior (AP) view as in angiography. 1, parieto-occipital artery; 2, lingual gyrus and calcarine artery; 3, calcar avis, atrium, and posterior transverse temporal gyrus; 4, vein of Galen; 5, glomus of atrium and sylvian point; 6, middle transverse temporal gyrus; 7, tentorial edge and trochlear nerve; 8, P2P segment of the posterior cerebral artery, parahippocampal gyrus, and fornix; 9, superior limiting sulcus of the insula; 10, inferior choroidal point (entry point of the anterior choroidal artery in the temporal horn); 11, Heschl’s gyrus; 12, lentiform nucleus; 13, crus cerebri; 14, apex and the posteromedial surface of the uncus and the anterior choroidal artery; 15, P1 segment of the posterior cerebral artery and the posterior communicating artery; 16, head of the hippocampus; 17, supraclinoid carotid artery and anteromedial surface of the uncus; 18, limen insulae and insular pole; 19, planum polare; 20, deep middle cerebral vein; 21, anterior cerebral artery and optic nerve; 22, lesser wing of the sphenoid; 23, genu of the MCA; M1, sphenoid segment of the MCA; M2, insular segment of the MCA; M3, opercular segment of the MCA; M4, cortical segment of the MCA; IE, insular edge. (Images courtesy of AL Rhoton, Jr.)

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