Study of microneurosurgical anatomy of middle cerebral artery in human cadaveric brain in the North Indian population

The understanding of normal brain anatomy and its intricate variations in vascular and other minute brain structures has dramatically improved over the past few years, facilitated by the phenomenal advancements made in the field of microneurosurgery. Cadaveric microdissection is of immense help, as it forms the basis of our understanding of the brain’s complex structures. Aim: Study of the microsurgical Anatomy of the Middle Cerebral Artery in the Human Cadaveric Brain in the North Indian population. Materials and methods: Fifteen fresh adult cadavers of both genders were studied in the Anatomy dissection hall of the ABVIMS, and Dr. R.M.L. Hospital, New Delhi, between 01-01-2021 and 15-04-2022. The entire examination was conducted under magnification, with a 10x zoom. Results: The average length of the M1 segment was 16.36 ± 2.973 mm. The average length of M1 in bifurcating cases was 15.32 mm. The average length of M1 in trifurcating cases was 19.25 mm. 33.33% had one early branch, 46.6% had two early branches, and 20.0% had three early branches. MCA bifurcated into superior and inferior trunks in 22 cases (73.3%). MCA trifurcated into superior, middle, and inferior trunks in 8 cases (26.6%). The angular artery was the largest cortical artery in 53.4% of cases. The temporo-occipital artery was the largest cortical artery in 46.6% of cases. The early branch to the frontal lobe was 20%. The average number of M1 segment perforators was 9.2. Conclusion: The detailed knowledge of microsurgical anatomy of MCA and its variations is important for neurosurgeons dealing with MCA aneurysm management.