Microanatomical study of the insular perforating arteries.

Acta neurochirurgica

PubMedID: 24986536

Delion M, Mercier P. Microanatomical study of the insular perforating arteries. Acta Neurochir (Wien). 2014;.
BACKGROUND
The insular perforating arteries originate from the middle cerebral artery. They have only been very partially described up to now. In the literature, they come from the M2 segment and three types are listed: the short, medium and long perforators. The first two types supply the claustrum as well as the external and extreme capsules.

OBJECTIVE
We describe the anatomy of long perforating insular arteries and their arterial contribution to the main white matter bundles of the oval center of Vieussens.

MATERIALS AND METHOD
Twenty adult cadaveric hemispheres were studied after perfusion of the arteries and veins with colored latex. The arteries were dissected and photographed under an operating microscope.

RESULTS
The long insular perforating arteries come from the M2 segment or from the junction of the M2 and M3 segments and sometimes from the M3 segment. They often perforate the insular cortex on the top of the posterior short insular gyrus and the insular long gyri, or in the superior peri-insular sulcus, before coming together in the oval center. At this level, they give arterial contribution to the main white matter bundles such as corticospinal and corticonuclear tracts for motricity, and the arcuate fasciculus and the occipitofrontal tract for language in the dominant hemisphere.

CONCLUSION
These perforating arteries have to be carefully respected during insular surgery to avoid neurologic weakness.