J Korean Neurosurg Soc.  2009 May;45(5):289-292. 10.3340/jkns.2009.45.5.289.

The Angiographic Feature and Clinical Implication of Accessory Middle Cerebral Artery

• Kim MS
• Lee HK

• KMID: 1495118
• DOI: http://doi.org/10.3340/jkns.2009.45.5.289

Abstract

OBJECTIVE
Although there are several descriptions of this vessel, there is no detailed angiographic study of the accessory middle cerebral artery (AMCA) in Korea. We describe the angiographic characteristics of the cortical territory and origin of AMCA and discuss the clinical significance of this anomaly.
METHODS
We searched for patients with AMCAs from a retrospective review of 1,250 conventional cerebral angiograms. We determined the origins, diameters and cortical territories of these AMCAs.
RESULTS
Fifteen patients (15 of 1250 = 1.2%) had 16 AMCAs (one patient had bilateral AMCAs). AMCAs originated from the distal A1 in eleven cases, middle A1 in two, proximal A1 in two, and proximal A2 in one case. All AMCAs followed a course parallel to the main middle cerebral artery (MCA). All but three of these arteries were smaller than the main MCA. Thirteen of the smaller diameter AMCAs had cortical distribution to the orbito-frontal and prefrontal, and precentral areas. Three AMCAs had diameter as large as the main MCA. These three supplied the orbitofrontal, prefrontal, precentral, central and anterior-parietal arteries.
CONCLUSION
The AMCAs originated from A1 or A2. Most had smaller diameter than the main MCA. The AMCAs coursed along the horizontal portion of the MCA, but supplied the orbital surface, the anterior frontal lobe and sometimes wider cortical territory, including the precentral, central, anterior-parietal areas.

Keyword

Accessory middle cerebral artery; Cortical territory; Clinical implication

MeSH Terms

Arteries
Frontal Lobe
Glycosaminoglycans
Humans
Korea
Middle Cerebral Artery
Orbit
Retrospective Studies
Tranexamic Acid
Glycosaminoglycans
Tranexamic Acid