MCA is an abbreviation for middle cerebral artery. It can be translated into Turkish as the middle cerebral artery. It can also be referred to as the middle cerebral artery. It is the largest of the three pairs of vessels that feed the brain. Others are the ACA (anterior cerebral artery) and PCA (posterior cerebral artery). They exist as a left and right pair. An MCA infarction is a blockage of a vessel due to a clot.

The MCA branches from the internal carotid artery, also known as the carotid artery. It carries blood to the outer (lateral) parts of the frontal, temporal and parietal lobes. These areas of the brain process the senses from the hand, arm, face and pharynx and control their movements.

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Parts of MCA

The middle cerebral artery is analyzed anatomically in three parts.

  • Horizontal segment (horizontal segment): It is also called the sphenoidal segment because it follows the sphenoid bone. The branches, called lateral lenticulostriate arteries, that come out of this part, enter the brain tissue. These vessels supply the basal ganglia located deep in the brain. Basal ganglia are responsible for unconscious control of movements.
  • Sylvian part: It carries blood to the temporal lobe and insular cortex. The temporal lobe takes over the processing of the sense of sound. The insular cortex or insula regulates some movement functions and matches emotions with experiences. The sylvian part is divided into two or three branches. Another structure found in this region is the operculum, which extends from the insula to the cortex. The sylvian part can sometimes be divided into two parts, the opercular and the insular part.
  • Cortical parts: The cerebral cortex carries blood to the cortex.
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The MCA can become narrowed or blocked by a clot during a stroke. Computed tomography (CT), magnetic resonance imaging (MRI), or MRI-angiography may be performed to demonstrate this. The clot can form and dislocate elsewhere in the body, such as the heart, and block the MCA. This is called a thromboembolic stroke.

Branches of MCA

A clot that completely blocks the main body of the MCA causes damage to most of the outer surface of that hemisphere of the brain. Since the upper branch (superior division) of the MCA feeds Broca’s area in the frontal lobe, speech disorder (motor aphasia) may develop in case of obstruction. The lower branch (inferior division) of the MCA supplies Wernicke’s area lateral to the temporal lobe. If this branch is blocked, Wernicke’s aphasia, which manifests itself with difficulty in understanding language, may occur. If the main body of MCA is blocked, global aphasia develops, which manifests itself with problems in both understanding and expressing language. The deep branches of the MCA go to the internal capsule with the basal ganglia.

MCA Infarction Findings

  • Weakness of the facial muscles, arm, and hand on the opposite side of the affected MCA ( hemiplegia ).
  • Loss of sensation in the contralateral face and arm.
  • Language impairment (aphasia) if the dominant cerebral hemisphere (usually the left hemisphere) is affected.
  • Neglect syndrome affecting the opposite side if the non-dominant cerebral hemisphere is affected.
  • In large MCA infarcts, especially in the acute period, the gaze of the person may shift to the lesion side. Restriction in the visual field, called homonimus hemianopsia, may develop on the opposite side.
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Healing Process After Clot To MCA

Clotting into the MCA is a variant of stroke. Stroke is a serious problem that requires immediate intervention. The earlier the treatment is started, the higher the success rate. In the first hours, clot-dissolving drugs can be effective. After the life-threatening situation is over, the physical therapy and rehabilitation process begins. The recovery period can last from a few months to a few years or even a lifetime, depending on the extent of the brain damage.

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