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A. Carotid Arterial System (continued)

Branches of the ICA include:

1. Ophthalmic artery

It arises in the cavernous sinus as the first major branch of the ICA. It passes through the optic canal to supply the eye and other structures of the orbit. Central artery of the retina is its most important branch. It ends by supplying a patch of skin on the medial aspect of the forehead (Gibo et al., 1981).

2. Posterior communicating artery (PoCA)

It arises just before the termination of the ICA and passes backward to join the first part of the posterior cerebral artery (PCA). This connection can be a vital link to one or the other in instances of disease. Unfortunately, in over twenty per cent of cases the artery on one or the other side is small and can not serve this function (Hoffman et al., 1974). It supplies the optic tract, chiasma, the thalamus, hypothalamus and the midbrain.

3. Anterior choroidal artery

It originates occasionally from the PoCA or the middle cerebral artery (MCA), the anterior choroidal artery usually arises from the ICA just beyond the origin of the PoCA. It supplies the choroid plexus of the lateral ventricle, the optic tract, the internal capsule, medial parts of the basal ganglia, the medial parts of the temporal lobe, the thalamus, the lateral geniculate body, the proximal optic radiation and the midbrain. The anterior and posterior choroidal arteries join the carotid and the vertebrobasilar systems (Goldberg 1974).

4. Anterior cerebral artery (ACA)

It passes anteromedially via the horizontal plane to enter the interhemispheric fissure, anastomoses with the contralateral ACA via the anterior communicating artery (ACoA) forming the anterior portion of the circle of Willis (Bosma 1977, Brisman et al., 1977 and Crowell and Morawetz 1977). It supplies the anterior and the medial parts of the cerebral hemispheres. Small branches (medial striate arteries) also supply parts of the optic nerve and chiasma, hypothalamus, anterior basal ganglia and internal capsule. One of these branches is of sufficient size to be named: the recurrent artery of Heubner, which supplies the anterior limb of the internal capsule (Dunker and Harris 1976).

5. Middle cerebral artery (MCA)

It is the largest branch of ICA and appears almost as its direct continuation. It passes laterally entering the Sylvian fissure and divides into two to four branches supplying the lateral parts of the cerebral hemispheres. It supplies most of the hemisphere including the bulk of the convexity except for thin superior and inferior strips. From its main stem, a medial and lateral group of tiny lenticulostriate arteries pass upwards to penetrate the base of the brain and supply the basal ganglia and the superior portion of the anterior and posterior limbs of the internal capsule (Marinkovic et al., 1985 and Dumansky et al., 1988).

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Article reviewed by:	Dr. Tamer Fouad, M.D.
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