Perforating branches of the middle cerebral artery

Microsurgical anatomy of their extracerebral segments

View More View Less
  • 1 Institute of Anatomy, Department of Neurology, and Institute of Social Medicine, Statistics and Health Research, University of Belgrade School of Medicine, Belgrade, Yugoslavia
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

✓ Perforating branches of the middle cerebral artery (MCA) were examined under magnification in 50 formalin-fixed brain hemispheres. Perforating vessels varied in number from three to 18, with an average of nine. The greater the number of vessels, the smaller was their diameter. In this study, the perforating arteries were divided into medial, middle, and lateral groupings. Those in the medial group usually arose directly from the MCA main trunk close to the carotid bifurcation. There were usually three vessels in the middle group, which originated not only from the MCA trunk, but also from the MCA collateral (cortical) branches. Common stems, when present, gave rise to individual perforating vessels and occasionally to thin olfactory and insular rami. Perforating arteries in the lateral group varied from one to nine in number. In addition to an origin from the MCA trunk, they also arose from cortical branches supplying the frontal and temporal lobes. The fact that lateral perforating vessels often originated from division sites and from terminal branches of the MCA is of clinical significance, because aneurysms are more commonly located at the MCA bifurcation. Anastomoses were not found among the perforating arteries. In two specimens, a fusion between a perforating artery and the MCA trunk was noted. Since the perforating vessels are obviously end arteries, injury to them must be avoided during operations for MCA aneurysms.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address reprint requests to: Miroslav S. Kovačević, M.D., D.Sc., Department of Neurology, University of Belgrade School of Medicine, Subotićeva 6, Belgrade 11000, Yugoslavia.
  • 1.

    Crompton MR: The pathology of ruptured middle-cerebral aneurysms with special reference to the differences between the sexes. Lancet 2:421425, 1962 Crompton MR: The pathology of ruptured middle-cerebral aneurysms with special reference to the differences between the sexes. Lancet 2:421–425, 1962

    • Search Google Scholar
    • Export Citation
  • 2.

    Dandy WE: Intracranial Arterial Aneurysms. New York: Hafner, 1969 (reprint of 1944 ed), pp 5058 Dandy WE: Intracranial Arterial Aneurysms. New York: Hafner, 1969 (reprint of 1944 ed), pp 50–58

    • Search Google Scholar
    • Export Citation
  • 3.

    Day AL: Indications for surgical intervention in middle cerebral artery obstruction. J Neurosurg 60:296304, 1984 Day AL: Indications for surgical intervention in middle cerebral artery obstruction. J Neurosurg 60:296–304, 1984

    • Search Google Scholar
    • Export Citation
  • 4.

    Edvinsson L, & Owman C: Neurovascular aminergic and peptidergic functions in brain and the possible pathophysiological role in cerebral vasospasm, in Goldstein M, , Bolis L, & Fieschi C, et al (eds): Cerebrovascular Disorders and Stroke. Advances in Neurology, Vol 25. New York: Raven Press, 1979, pp 2338 Edvinsson L, Owman C: Neurovascular aminergic and peptidergic functions in brain and the possible pathophysiological role in cerebral vasospasm, in Goldstein M, Bolis L, Fieschi C, et al (eds): Cerebrovascular Disorders and Stroke. Advances in Neurology, Vol 25. New York: Raven Press, 1979, pp 23–38

    • Search Google Scholar
    • Export Citation
  • 5.

    Espinosa F, , Weir B, & Boisvert D, et al: Chronic cerebral vasospasm after large subarachnoid hemorrhage in monkeys. J Neurosurg 57:224232, 1982 Espinosa F, Weir B, Boisvert D, et al: Chronic cerebral vasospasm after large subarachnoid hemorrhage in monkeys. J Neurosurg 57:224–232, 1982

    • Search Google Scholar
    • Export Citation
  • 6.

    Ferner H, & Kautzky R: Angewandte Anatomie des Gehirns und seiner Hüllem, in Olivecrona H, & Tönnis W (eds): Handbuch der Neurochirurgie. Berlin/Heidelberg/New York: Springer-Verlag, 1959, Vol I, Part 1, pp 190 (see pp 39–53) Ferner H, Kautzky R: Angewandte Anatomie des Gehirns und seiner Hüllem, in Olivecrona H, Tönnis W (eds): Handbuch der Neurochirurgie. Berlin/Heidelberg/New York: Springer-Verlag, 1959, Vol I, Part 1, pp 1–90 (see pp 39–53)

    • Search Google Scholar
    • Export Citation
  • 7.

    Fisher CM: Lacunar strokes and infarcts: a review. Neurology 32:871876, 1982 Fisher CM: Lacunar strokes and infarcts: a review. Neurology 32:871–876, 1982

    • Search Google Scholar
    • Export Citation
  • 8.

    Garrido E, & Stein BM: Middle cerebral artery embolectomy. Case report. J Neurosurg 44:517521, 1976 Garrido E, Stein BM: Middle cerebral artery embolectomy. Case report. J Neurosurg 44:517–521, 1976

    • Search Google Scholar
    • Export Citation
  • 9.

    Hamby WB: Intracranial surgery for aneurysms. Prog Neurol Surg 3:165, 1969 (see pp 49–51) Hamby WB: Intracranial surgery for aneurysms. Prog Neurol Surg 3:1–65, 1969 (see pp 49–51)

    • Search Google Scholar
    • Export Citation
  • 10.

    Jacobson JH II, , Wallman LJ, & Schumacher GA, et al: Microsurgery as an aid to middle cerebral artery endarterectomy. J Neurosurg 19:108115, 1962 Jacobson JH II, Wallman LJ, Schumacher GA, et al: Microsurgery as an aid to middle cerebral artery endarterectomy. J Neurosurg 19:108–115, 1962

    • Search Google Scholar
    • Export Citation
  • 11.

    Kaneko M, , Koba T, & Yokoyama T: Early surgical treatment for hypertensive intracerebral hemorrhage. J Neurosurg 46:579583, 1977 Kaneko M, Koba T, Yokoyama T: Early surgical treatment for hypertensive intracerebral hemorrhage. J Neurosurg 46:579–583, 1977

    • Search Google Scholar
    • Export Citation
  • 12.

    Kaplan HA: The anatomy of the perforating arteries of the basal ganglia, in Salamon G (ed): Advances in Cerebral Angiography. Anatomy, Stereotaxy, Embolization, Computerized Axial Tomography. Berlin/Heidelberg/New York: Springer-Verlag, 1975, pp 3336 Kaplan HA: The anatomy of the perforating arteries of the basal ganglia, in Salamon G (ed): Advances in Cerebral Angiography. Anatomy, Stereotaxy, Embolization, Computerized Axial Tomography. Berlin/Heidelberg/New York: Springer-Verlag, 1975, pp 33–36

    • Search Google Scholar
    • Export Citation
  • 13.

    Kaplan HA: Arteries of the brain. An anatomic study. Acta Radiol 46:364370, 1956 Kaplan HA: Arteries of the brain. An anatomic study. Acta Radiol 46:364–370, 1956

    • Search Google Scholar
    • Export Citation
  • 14.

    Kaplan HA: The lateral perforating branches of the anterior and middle cerebral arteries. J Neurosurg 23:305310, 1965 Kaplan HA: The lateral perforating branches of the anterior and middle cerebral arteries. J Neurosurg 23:305–310, 1965

    • Search Google Scholar
    • Export Citation
  • 15.

    Krayenbühl H, & Yaşargil MG: Zerebrale Angiographie für Klinik und Praxis, ed 3. P Huber, editor. Stuttgart: Georg Thieme, 1979, pp 325382 Krayenbühl H, Yaşargil MG: Zerebrale Angiographie für Klinik und Praxis, ed 3. P Huber, editor. Stuttgart: Georg Thieme, 1979, pp 325–382

    • Search Google Scholar
    • Export Citation
  • 16.

    Lazorthes G, , Salamon G, & Gouaze A, et al: The central arteries of the brain. Classification and territories of vascular supply, in Salamon G (ed): Advances in Cerebral Angiography. Berlin/Heidelberg/New York: Springer-Verlag, 1975, pp 3741 Lazorthes G, Salamon G, Gouaze A, et al: The central arteries of the brain. Classification and territories of vascular supply, in Salamon G (ed): Advances in Cerebral Angiography. Berlin/Heidelberg/New York: Springer-Verlag, 1975, pp 37–41

    • Search Google Scholar
    • Export Citation
  • 17.

    Leeds NE: The striate (lenticulostriate) arteries and the artery of Heubner, in Newton TH, & Potts DG (eds): Radiology of the Skull and Brain. St Louis: CV Mosby, 1974, Vol 2, Book 2, pp 15271539 Leeds NE: The striate (lenticulostriate) arteries and the artery of Heubner, in Newton TH, Potts DG (eds): Radiology of the Skull and Brain. St Louis: CV Mosby, 1974, Vol 2, Book 2, pp 1527–1539

    • Search Google Scholar
    • Export Citation
  • 18.

    Lougheed WM, , Gunton RW, & Barnett HJM: Embolectomy of internal carotid, middle and anterior cerebral arteries. Report of a case. J Neurosurg 22:607609, 1965 Lougheed WM, Gunton RW, Barnett HJM: Embolectomy of internal carotid, middle and anterior cerebral arteries. Report of a case. J Neurosurg 22:607–609, 1965

    • Search Google Scholar
    • Export Citation
  • 19.

    McCormick WF: Vascular disorders of nervous tissue: anomalies, malformations, and aneurysms, in Bourne GH (ed): The Structure and Function of Nervous Tissue. New York: Academic Press, 1969, Vol 3, pp 537596 McCormick WF: Vascular disorders of nervous tissue: anomalies, malformations, and aneurysms, in Bourne GH (ed): The Structure and Function of Nervous Tissue. New York: Academic Press, 1969, Vol 3, pp 537–596

    • Search Google Scholar
    • Export Citation
  • 20.

    Rosner SS, , Rhoton AL Jr, & Ono M, et al: Microsurgical anatomy of the anterior perforating arteries. J Neurosurg 61:468485, 1984 Rosner SS, Rhoton AL Jr, Ono M, et al: Microsurgical anatomy of the anterior perforating arteries. J Neurosurg 61:468–485, 1984

    • Search Google Scholar
    • Export Citation
  • 21.

    Rowbotham GF, & Little E: Circulations of the cerebral hemispheres. Br J Surg 52:821, 1965 Rowbotham GF, Little E: Circulations of the cerebral hemispheres. Br J Surg 52:8–21, 1965

    • Search Google Scholar
    • Export Citation
  • 22.

    Sakaki T, , Kinugawa K, & Tanigake T, et al: Embolism from intracranial aneurysms. J Neurosurg 53:300304, 1980 Sakaki T, Kinugawa K, Tanigake T, et al: Embolism from intracranial aneurysms. J Neurosurg 53:300–304, 1980

    • Search Google Scholar
    • Export Citation
  • 23.

    Sundt TM Jr, , Kobayashi S, & Fode NC, et al: Results and complications of surgical management of 809 intracranial aneurysms in 722 cases. Related and unrelated to grade of patient, type of aneurysm, and timing of surgery. J Neurosurg 56:753765, 1982 Sundt TM Jr, Kobayashi S, Fode NC, et al: Results and complications of surgical management of 809 intracranial aneurysms in 722 cases. Related and unrelated to grade of patient, type of aneurysm, and timing of surgery. J Neurosurg 56:753–765, 1982

    • Search Google Scholar
    • Export Citation
  • 24.

    Suzuki J, , Yoshimoto T, & Kayama T: Surgical treatment of middle cerebral artery aneurysms. J Neurosurg 61:1723, 1984 Suzuki J, Yoshimoto T, Kayama T: Surgical treatment of middle cerebral artery aneurysms. J Neurosurg 61:17–23, 1984

    • Search Google Scholar
    • Export Citation
  • 25.

    Wende S, , Zieler E, & Nakayama N: Cerebral Magnification Angiography. Physical Basis and Clinical Results. Berlin/Heidelberg/New York: Springer-Verlag, 1974, pp 123128 Wende S, Zieler E, Nakayama N: Cerebral Magnification Angiography. Physical Basis and Clinical Results. Berlin/Heidelberg/New York: Springer-Verlag, 1974, pp 123–128

    • Search Google Scholar
    • Export Citation
  • 26.

    Westberg G: The recurrent artery of Heubner and the arteries of the central ganglia. Acta Radiol (Diagn) 1:949954, 1963 Westberg G: The recurrent artery of Heubner and the arteries of the central ganglia. Acta Radiol (Diagn) 1:949–954, 1963

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 526 254 20
Full Text Views 263 33 5
PDF Downloads 197 19 4
EPUB Downloads 0 0 0