Accessory middle cerebral artery
Citation, DOI, disclosures and article data
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosuresAt the time the article was last revised Antonio Rodrigues de Aguiar Neto had no recorded disclosures.
View Antonio Rodrigues de Aguiar Neto's current disclosures- Accessory MCA
The accessory middle cerebral artery is a variant of the middle cerebral artery (MCA) that arises from the anterior cerebral artery (ACA). It is different from a duplicated middle cerebral artery, in which the duplicated vessel originates also from the distal end of the internal carotid artery (ICA).
On this page:
Epidemiology
The prevalence of accessory MCA is ~2%.
Gross anatomy
It runs parallel to the course of the MCA and supplies some of the MCA territory. The accessory MCA typically supplies anterior frontal lobe.
Accessory MCA may arise from either the proximal or distal portion of the A1 segment of the ACA. There are classification systems (Teal and Manelfe) which reflect this.
Other common embryological variants of the MCA include duplicated middle cerebral artery (vessel arising from the ICA bifurcation, and typically supplying the anterior temporal lobe), and fenestrated middle cerebral artery.
Embryology
Accessory MCA may be present due to the persistence of two perforators. Early suggestions that the anomaly arises from a hypertrophied recurrent artery of Heubner (RAH) are now thought unlikely, as RAH often coexists, and the territory of supply is different. The vessel may be an anomalous early branch of the MCA.
ADVERTISEMENT: Supporters see fewer/no ads
Related pathology
There is an association between MCA variants and intracranial aneurysms. It is important to accurately document MCA anomalies as they have implications for operative or endovascular management.
References
- 1. Arslan EB, Oztürk A, Oğuz KK. Incidental bilateral accessory middle cerebral arteries on MR imaging and MR angiography. Diagn Interv Radiol. 2007;13 (1): 10-2. Diagn Interv Radiol (link) - Pubmed citation
- 2. Komiyama M, Nakajima H, Nishikawa M et-al. Middle cerebral artery variations: duplicated and accessory arteries. AJNR Am J Neuroradiol. 1998;19 (1): 45-9. AJNR Am J Neuroradiol (abstract) - Pubmed citation
- 3. Duarte-Valdivieso NC, Wong HF, Moscote-Salazar LR, Aquino-Matus J, Calderon-Miranda WG, Agrawal A. Accessory middle cerebral artery: An uncommon finding. J Neurosci Rural Pract. 2017;8(S1):S139-S141. Pubmed citation
Incoming Links
Related articles: Anatomy: Brain
-
brain
- grey matter
- white matter
-
cerebrum
-
cerebral hemisphere (telencephalon)
- cerebral lobes and gyri
- frontal lobe
- parietal lobe
-
occipital lobe
- occipital pole
- lingual gyrus
- fusiform gyrus (Brodmann area 37)
- calcarine (visual) cortex
- cuneus
- temporal lobe
- basal forebrain
- limbic system
- insula
-
cerebral sulci and fissures (A-Z)
- calcarine fissure
- callosal sulcus
- central (Rolandic) sulcus
- cingulate sulcus
- collateral sulcus
- inferior frontal sulcus
- inferior occipital sulcus
- inferior temporal sulcus
- interhemispheric fissure
- intraparietal sulcus
- lateral (Sylvian) sulcus
- lateral occipital sulcus
- marginal sulcus
- occipitotemporal sulcus
- olfactory sulcus
- paracentral sulcus
- paraolfactory sulcus
- parieto-occipital fissure
- posterior parolfactory sulcus
- precentral sulcus
- preoccipital notch
- postcentral sulcus
- rhinal sulcus
- rostral sulcus
- subparietal sulcus
- superior frontal sulcus
- superior occipital sulcus
- superior temporal sulcus
- cortical histology
- cerebral lobes and gyri
- white matter tracts
- deep grey matter
-
pituitary gland
- posterior pituitary and stalk (part of diencephalon)
- anterior pituitary
- inferior hypophyseal arterial circle
- diencephalon
-
cerebral hemisphere (telencephalon)
-
brainstem
- midbrain (mesencephalon)
- pons (part of metencephalon)
- medulla oblongata (myelencephalon)
- white matter
-
grey matter
- non-cranial nerve
-
cranial nerve nuclei
- oculomotor nucleus
- Edinger-Westphal nucleus
- trochlear nucleus
- motor nucleus of CN V
- mesencephalic nucleus of CN V
- main sensory nucleus of CN V
- spinal nucleus of CN V
- abducent nucleus
- facial nucleus
- superior salivatory nucleus
- cochlear nuclei
- vestibular nuclei
- inferior salivatory nucleus
- solitary tract nucleus
- ambiguus nucleus
- dorsal vagal motor nucleus
- hypoglossal nucleus
-
cerebellum (part of metencephalon)
- vermis
- cerebellar hemisphere
- cerebellar peduncles
- cranial meninges (meninx primitiva)
- CSF spaces
-
cranial nerves (mnemonic)
- olfactory nerve (CN I)
- optic nerve (CN II)
- oculomotor nerve (CN III)
- trochlear nerve (CN IV)
- trigeminal nerve (CN V) (mnemonic)
- abducens nerve (CN VI)
- facial nerve (CN VII) (segments mnemonic | branches mnemonic)
-
vestibulocochlear nerve (CN VIII)
- vestibular ganglion (Scarpa's ganglion)
- glossopharyngeal nerve (CN IX)
- vagus nerve (CN X)
- spinal accessory nerve (CN XI)
- hypoglossal nerve (CN XII)
- functional neuroanatomy
- CNS development
- cerebral vascular supply
- arteries
- vascular territories
-
circle of Willis
- internal carotid artery (ICA) (segments)
- vertebral artery
-
normal variants
- intracranial arterial fenestration
- internal carotid artery (ICA)
- anterior cerebral artery (ACA)
- middle cerebral artery (MCA)
- posterior cerebral artery (PCA)
- basilar artery
- persistent carotid-vertebrobasilar artery anastomoses (mnemonic)
- vertebral artery
- ophthalmic artery
-
cerebral venous system
-
dural venous sinuses
- basilar venous plexus
- cavernous sinus (mnemonic)
- clival diploic veins
- inferior petro-occipital vein
- inferior petrosal sinus
- inferior sagittal sinus
- intercavernous sinus
- internal carotid artery venous plexus of Rektorzik
- jugular bulb
- marginal sinus
- occipital sinus
- sigmoid sinus
- sphenoparietal sinus
- straight sinus
- superior petrosal sinus
- superior sagittal sinus
- torcula herophili
- transverse sinus
-
cerebral veins
-
superficial veins of the brain
- superior cerebral veins (superficial cerebral veins)
- inferior cerebral veins
- superficial middle cerebral vein
- superior anastomotic vein (of Trolard)
- inferior anastomotic vein (of Labbe)
-
superficial veins of the brain
-
deep veins of the brain
- great cerebral vein (of Galen)
- venous circle of Trolard
- normal variants
-
dural venous sinuses
- arteries
- glymphatic pathway
Unable to process the form. Check for errors and try again.