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Branch of the middle cerebral artery in the brain cortex arterial blood supply side surface of the cerebral hemispheres, with the exception of the frontal pole, strip, located along the border verhnevnutrenney frontal lobe, which are supplied with arterial blood, anterior cerebral artery, and the lower temporal gyrus related to the basin of the posterior cerebral artery.
Middle cerebral artery supplies arterial blood following brain regions:
- • cortex and white matter of the brain from the side and bottom of the frontal lobe
- • motor cortex (fields 4 and 6, the cortical centers of sight, motor speech center in the dominant hemisphere Broca's area)
- • cortex and white matter of the brain side of the parietal lobe (sensory cortex, angular gyrus and supramarginal)
- • lateral and upper parts of the temporal lobe and the islet brain
Perforating branches of the middle cerebral artery supplying arterial blood following brain regions:
- • putamen
- • outer division of the globus pallidus of the brain
- • posterior thigh of the internal capsule below the plane that intersects the upper boundary of the globus pallidus
- • adjacent part of the radiate crown
- • body of the caudate nucleus
- • upper and lateral segments of the head of the caudate nucleus
Embolism and thrombosis, most often exposed to middle cerebral artery basin vessels. With complete occlusion of the lumen (occlusion) blocked artery trunk as perforating branches to the deep white and gray matter of the brain, and large branches to the surface of the cerebral cortex. The classic picture of the lesion is characterized by hemiplegia (paralysis of half of the body) and unilateral anesthesia (loss of sensitivity than half of the body) on the opposite side of the body.
With involvement in the pathological process in the dominant hemisphere stroke patient's brain, there is also a total sensorimotor aphasia (impairment of perception and reproduction of speech). In cases of non-dominant hemisphere lesions of the brain clinical symptom complex is complemented apraktoagnoziey and anosognosia (inability to understand or recognize objects). If the patient has dysarthria (impairment proper motion of the vocal apparatus during speech playback), then dysphasia (impairment of speech perception and reproduction) is observed.
Visible neurologic manifestations of lesions of the middle cerebral artery basin often noted at occlusion (occlusion) of the lumen of this artery trunk embolus. To establish an effective collateral blood circulation of the cerebral cortex at a specific time, but it leads to the development of partial occlusion of the lumen of syndromes in the trunk of the middle cerebral artery on the background of its atherosclerosis with subsequent thrombosis.
Partial neurological syndromes are also found at middle cerebral artery basin embolism. Embolus can get into the trunk of the artery, to spread further upward (distally), penetrate into the overlying (distal) branch and subject to further dilution (lysis). In accordance with the process objective and subjective neurological symptoms varies. Certain syndromes are diseases caused by embolic occlusion (occlusion) of one of the branches include:
- • weakness in the wrist
- • only weakness of the upper extremity (shoulder syndrome)
- • lesion mimic muscles with motor aphasia and weakness in his hand or without it (frontal opercular syndrome)
Sensory impairments, weakness in the limbs and motor aphasia suggests embolism at the site of exit from the upper branches of the division. When re-aphasia without paresis, probably a lesion in the lower division of the middle cerebral artery, as coming from a branch supply blood to the rear area of ??the dominant hemisphere sensory cortex. The sudden appearance of the difficulties caused by ignoring half of the body and spatial agnosia, with no evidence of paralysis of the lower division of the damage of the middle cerebral artery non-dominant hemisphere of the brain of the patient.