Microsurgical anatomy of the pterional approach to the middle cerebral artery and their clinical signification

Objective: To study more detailed anatomic datum of the middle cerebral artery and its perforating arteries through pterional approach.Methods:Microsurgical anatomy and measurement about the perforating arteries were performed in both sides of 10 adults red-latex perfused cadaver heads along with the path of pterional approach under the surgical microscope.Results:Middle cerebral artery was the continue from inner carotid artery,and then the middle cerebral artery divided into M1 to M5 segments.Most perforating arteries arose from superior,medial-superior of middle cerebral artery and coursed superiorly to the center of brain.The perforating arteries were divided into two groups: the inner group and outer group.Many outer group perforating arteries arose from the beginning level of M2 segment within 2mm.Conclusion:There are many perforating arteries arose from middle cerebral artery with a right-angle,and the speed of blood in middle cerebral artery very high,which may be related to the block and bleeding of cerebra.M1 and M2 segment should be dissected at their underside,that the injury of the perforating arteries which arising from M1 and M2 can be avoided.