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Artery of precentral sulcus

The Artery of the Precentral Sulcus is a small yet significant cerebral vessel supplying the lateral portion of the precentral gyrus—an area critical for motor function. This artery typically arises from the middle cerebral artery’s (MCA) superior trunk, though variations in origin exist. Knowledge of this artery’s course and vascular territory is vital in neurosurgery and neuroradiology, particularly in cases of stroke or surgical planning near the primary motor cortex. Imaging modalities such as MRI and CT angiography can visualize this artery, especially in pathological states.

Synonyms

  • Precentral Sulcal Artery

  • Precentral Artery

  • Precentral Branch of MCA

  • Sulcal Artery of Precentral Sulcus

Origin and Course

  • Most often originates from the superior division of the Middle Cerebral Artery (MCA) (M2 segment).

  • Less commonly, it may arise from the cortical branches of the MCA, occasionally as a direct branch.

  • Courses superiorly and posteriorly, running within or adjacent to the precentral sulcus (the groove just anterior to the central sulcus).

  • Supplies the lateral aspect of the precentral gyrus (primary motor cortex), sometimes also giving minor branches to adjacent frontal gyri.

  • May anastomose with nearby sulcal arteries, including the central and postcentral sulcal arteries.

Function

  • Provides arterial blood supply to the precentral gyrus, the cortical area responsible for voluntary motor control.

  • Critical in maintaining the metabolic demands of upper motor neuron cell bodies.

  • Occlusion may result in focal motor deficits or precentral gyrus infarction.

MRI Appearance

  • Normally not visualized on standard MRI unless high-resolution angiographic sequences are used (e.g., 3D TOF MRA).

  • In vascular pathology (e.g., infarct, arteriovenous malformation, or vessel thrombosis), may be visualized as a flow void, loss of normal signal, or abnormal enhancement.

  • On MR angiography, appears as a fine linear or curvilinear vessel adjacent to the precentral sulcus.

CT Appearance

  • Usually not visible on non-contrast CT due to its small caliber.

  • CT Angiography (CTA): May be faintly visualized as a thin, linear, enhancing structure near the precentral sulcus.

  • Pathological states (e.g., acute infarct, vessel occlusion) may show loss of arterial enhancement or a subtle hyperdense artery sign in some cases.

  • Indirect signs of compromise include hypodensity in the corresponding cortical area (precentral gyrus) in case of infarction.

MRI images

Artery of precentral sulcus MRI 3T coronal image