Fig. 5. Branching patterns and anomalies of middle cerebral artery (MCA). (A) Single trunk MCA (0.2% to 20.6%): main trunk (blue arrow) continues without dividing into trunks. (B) Early bifurcation of MCA (0.5% to 24%): main trunk bifurcates (blue arrow) at a distance of ≤5 mm from origin. (C) Bifurcation (blue arrow) of MCA into upper and lower trunks (48% to 98%). (D) Trifurcation (blue arrow) of MCA into upper, middle and lower trunks (1% to 29%). (E) Quadrifurcation (blue arrow) of MCA into four branches (0.7% to 3.8%). (F) Duplication of MCA (0.5% to 2.9%)-duplicated vessel (blue arrow) originates from internal carotid artery (ICA) and runs parallel to the main trunk of MCA. (G) Accessory MCA (0.1% to 2.7%)-it originates from anterior cerebral artery (ACA) and runs parallel to main trunk of MCA (blue arrow). (H) Fenestration of MCA (0.1% to 3%)-division of artery into 2 lumens (blue arrow) that unite distally.
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