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An accessory middle cerebral artery is one variation of the intracranial vasculature that may be a source of misinterpretation by clinicians dealing with cerebrovascular diseases. We report a case of an elderly female found to have bilateral accessory middle cerebral arteries, who presented with the rupture of an aneurysm of the anterior part of the circle of Willis. Accessory middle cerebral arteries are rare anatomical findings and the bilateral occurrence is exceedingly rare. We believe this to be the first report of bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior cerebral-anterior communicating arteries. The anatomical and clinical relevance of this variation is described.
The main branches of the middle cerebral artery were defined in 16 cerebral hemispheres. It was observed that in 14 (87.5%) hemispheres, the main trunk of the middle cerebral artery bifurcated into two common branches which, in turn, branched further into cortical branches.
The anatomical structure of the middle cerebral artery in domestic pig (Sus scrofa f. domestica) was defined using 88 cerebral hemispheres. It was observed that the artery ramified into ten permanent branches. Two rhinal arteries supplied the area of cerebrum on the border between the old and the new cerebral cortex. The other eight branches bifurcated into three branches going into the frontal area, two branches - the parietal area and three temporal branches which supplied the new cerebral cortex exclusively. In domesic pig, most frequently, 38.7 %, the rostral cerebral artery gave rise to two and, in 59.1%, three independent branches. In one hemisphere (1.1%) the rostral cerebral artery gave rise to one main trunk of the middle cerebral artery. Similarly in one individual there were observed six independent branches of that artery.
Anatomical arrangement of the middle cerebral artery in the wild boar was described based on 92 brain hemispheres. The artery was found to form 10 branches. Two rhinal arteries supply the part of cerebrum situated between the old and new cortex. Of the remaining 8 branches three are directed to the frontal region, two to the parietal region, while three temporal branches supply blood only to the new cortex. In the wild boar in 62% cases the rostral cerebral artery gave two, and in 38% cases three independent branches.
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