Abstract
Introduction & Aim: The middle cerebral artery arises from the internal carotid artery as the terminal branch. It runs in the stem of lateral fissure as M1 segment and then on the insula as M2 segment with branches. The adjacent opercular cortex supplied by M3 and M4 segment. The aim of study was to record variations in branching pattern of middle cerebral artery in reference to insular cortex.
Material & Method: Formalin fixed 29 brains (58 right and left cerebral hemispheres) were studied at department of Anatomy, Gandhi medical college Bhopal. In the sylvian fissure the branching pattern and variations of middle cerebral artery observed. With the help of Digital Vernier Caliper and magnifying glasses the lengths of M1 & M2 segments recorded.
Result: The bifurcation pattern was present in 96.55% (56/58) cerebral hemispheres. The Mean length of the M1 segment of middle cerebral artery right side 14.63 ± 2.16 mm & left side 15.73 ± 2.54 mm. & M2 segment of middle cerebral artery superior trunk, right side 41.41 ± 8.48 mm, left side 40.18 ± 9.65 mm. and Inferior trunk, right side 49.63 ± 9.67 mm, left side 49.17 ± 9.71 mm.
Conclusion: Bifurcation is more common than trifurcation and the Mean length of Inferior trunk was more than superior trunk in both right and left side. In case of acute middle cerebral artery infarction, the blood supply of insular cortex gets affected and results in diagnostic radiological sign.
Keywords: morphology, morphometric, M2 segment middle cerebral artery, superior and inferior trunk, insular cortex.
References
- Albert Rhoton; Cranial anatomy and Surgical Approaches, Neurosurgery. Rhoton’s Anatomy, volume 53,part 2, October 2003, page 26 – 156
- Peele T.L; The neuroanatomic basis for clinical neurology 2nd McGraw Hill, Blackstone Division , London 1961.
- Tanriover N, Kawashima M. Rhoton Jr A et al. Microsurgical anatomy of the insula and sylvian fissure. J Neurosurg. 2004-May 100(5):891922
- Ture U, Yasargil MG. AI-Mefty O, Yasargil DCH. Arteries of the insula. Neurosurgery 2000; 92:676-687
- Standring S. Gray’s Anatomy. Arterial Supply of Brain. 40th Spain: Elsevier Ltd.; 2008:250.
- Osborn AG: Diagnostic Neuroadiology, ed I. St. Louis: Mosby, Inc, 1994, pp 136-138.
- Yasargil MG. Middle Cerebral Artery Microneurosurgery. Vol I. New York: Georg Thieme Verlag: 1982:72.
- Kiernan JA, Blood Supply of the central nervous system. In: Kiernan JA, Ed. In: Barr’s the Human Nervous System: An Anatomical Viewpoint. Philadelphia: Lippincott-Raven: 1998:439-455.
- Ring BA. Middle cerebral artery: anatomical and radiographic study. Acta Radiol. 1962:57(4):289-300.
- Lima P. Cerebral Angiography. New York: Oxford University Press: 1950.
- Pai SB, Varma RG, Kulkarni RN. Microsurgical anatomy of middle cerebral artery. Neurology. 2005:53:186-190.
- C Cereda, J Ghika, P .Maeder .Strokes restricted to the insular cortex. Neurology December 24, 2002; 59 (12). L6
- Karen Cilliers, Benedict John PAGE. Anatomy of the Middle Cerebral Artery: Cortical Branches, Branching Pattern and Anomalies. DOI: 10.5137/1019-5149.JTN. 18127-2016
- S Sundari et al. Branching Pattern of Middle Cerebral Artery IJSR ISSN: 2319-7064,Volume 5 Issue 11, November 2016.
- CP Rivera, A Veneziani RE Ware. Original Research sickle cell anemia and pediatric strokes – computationl fluid dynamics analysis in the middle cerebral artery –-biology and medicine, 2016.
- Tamura A, Kasai T, et al.Long insular artery infarction: characteristics of a previously unrecognized entity. AJNR Am J Neuroradiol. 2014. Mar; 35(3): 466-71.
- Preservation of the long insular artery to prevent postoperative motor deficits after resection of insular – opercular glioma: Technical Case reports. Neurol Med Chir (Tokyo). 2014 April; 54(4): 321-326.
Corresponding Author
Dr Vandana Sharma
Associate Professor and Head, Dept of Anatomy,
Gandhi Medical College, Bhopal (MP). Pin code 462001
Mob: +9229692241, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.110
