Trifurcated middle cerebral artery

Case contributed by Dr Muhammad Shoyab

Presentation

Transient weakness of left lower leg.

Patient Data

Age: 50 years
Gender: Female

MR Cerebral Angiogram

MRI

M2 segment of left middle cerebral artery divides into three branches instead of two.

MRA 3D Reconstruction

Annotated image

Case Discussion

The commonest pattern (around 80%) of branching of the MCA is by bifurcation of the M2 segment into superior and inferior divisions. About 10% make trifurcations and another 10% split into more than three branches.

One implication of such branching pattens is that the point of division is prone to aneurysms and pseudoaneurysms.

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