Middle Cerebral Artery - Neurointerventional Atlas

The middle cerebral artery (MCA) arises from the internal cerebral artery and is one of three major cerebral arteries that provide blood flow to the cerebrum. It traverses along the lateral sulcus and then branches along the lateral cerebral cortex.

Middle Cerebral Artery Branches along the surface of the cerebrum

Middle cerebral artery angiogram (patient has a hypoplastic A1 segment and an absent posterior communicating artery). Source

As with all vessels, variation is of course possible with the middle cerebral artery. Here is an example of an Accessory MCA:

In this case, there are two equally large proximal MCA vessels which branch from the right ICA terminus.

Accessory MCAs can become clinically relevant in the case of stroke. I.e. you don’t want to dismiss an accessory MCA occlusion in a symptomatic patient. The M1 may look normal, but in fact, the accessory MCA is occluded. Perfusion scans and distal vasculature should be abnormal.