A Pediatric Case of Aplastic or Twig-like Middle Cerebral Artery Presenting with Intracerebral Hemorrhage

裕希, 松永; 圭介, 堤; 陽一, 諸藤; 隆史, 藤本; 一郎, 川原; 英昭, 高畠; 智憲, 小野; 啓介, 戸田; 啓至, 馬場; 博明, 横山; 健太郎, 林; 泉, 永田

doi:10.2335/scs.42.51

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…17 , 18 3) There would be many pediatric cases if T-MCA were a congenital anomaly, but such reports are extremely rare. 11 , 19 Ota and Komiyama 13 suggested that T-MCA may be a secondary collateral after segmental steno-occlusive change of the proximal MCA and that this twig-like configuration may occur in the distal MCA or other arteries. 12 , 13 No cases or evidence of acquired T-MCA formation have been reported so far, but the first case of de novo T-MCA formation was reported recently.…”

Section: Discussionmentioning

confidence: 99%

Twig-like middle cerebral artery as a variety of isolated middle cerebral artery disease with new vessel formation: illustrative case

Nakajima,

Miyake,

Iwaki

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Twig-like middle cerebral artery (T-MCA) is reported as a rare vascular anomaly characterized by reconstitution of the M1 segment of the middle cerebral artery (MCA) by a plexiform network of small vessels. Although it is generally believed that the etiology of T-MCA is an embryological persistence, some investigators have suggested that T-MCA may be a secondary consequence. Here, the authors report a second case of de novo T-MCA formation and reconsider the concept of T-MCA in connection with isolated MCA disease. OBSERVATIONS A 40-year-old man’s brain magnetic resonance imaging (MRI) checkup showed moderate stenosis of the M1 segment of the left MCA. Annual MRI follow-up was planned, and when performed 1 year later, it showed occlusion of the M1 segment of the left MCA. Cerebral angiography revealed occlusion of that M1 segment with abnormal arterial networks. This case was diagnosed as de novo T-MCA. The patient has remained asymptomatic for 2 years. LESSONS The reports of de novo T-MCA indicate that acquired factors may be involved in the pathogenesis of T-MCA. We suggest that T-MCA should be defined as a variety of isolated MCA disease with new vessel formation.

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Section: Discussionmentioning

confidence: 99%

Twig-like middle cerebral artery as a variety of isolated middle cerebral artery disease with new vessel formation: illustrative case

Nakajima,

Miyake,

Iwaki

et al. 2024

Journal of Neurosurgery: Case Lessons

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show abstract

“…[ 5 , 7 ] 3) If T-MCA were a congenital anomaly, there would be many pediatric cases but such reports are rare. [ 2 , 16 ] These facts make it difficult to assume that the embryonic arterial network persists into late adulthood. Ota and Komiyama suggested that the T-MCA may be acquired as collateral circulation after partial stenoocclusive changes in the proximal MCA[ 19 , 20 ] but no cases or evidence of acquired T-MCA formation have been reported.…”

Section: Discussionmentioning

confidence: 99%

De novo formation of twig-like middle cerebral artery: An illustrative case

Kajita

Yanaka

Hanai

et al. 2023

Surgical Neurology International

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Background: Twig-like middle cerebral artery (T-MCA) is a rare vascular abnormality characterized by the replacement of the M1 segment of the middle cerebral artery (MCA) with a plexiform arterial network of small vessels. T-MCA is generally regarded as an embryological persistence. Conversely, T-MCA may also be a secondary sequela but no reports of cases of de novo formation exist. Here, we report the first case describing possible de novo T-MCA formation. Case Description: A 41-year-old woman was referred to our hospital from a nearby clinic because of transient left hemiparesis. Magnetic resonance (MR) imaging revealed mild stenosis of the bilateral MCAs. The patient then underwent MR imaging follow-ups once a year. MR imaging at the age of 53 showed a right M1 occlusion. Cerebral angiography revealed a right M1 occlusion and formation of a plexiform network consistent with the occlusion site, leading to the diagnosis of de novo T-MCA. Conclusion: This is the first case report describing possible de novo T-MCA formation. Although a detailed laboratory examination did not confirm the etiology, autoimmune disease was suspected to have precipitated this vascular lesion.

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Twig-like middle cerebral arteries: Clinical and radiological findings

et al. 2021

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A Pediatric Case of Aplastic or Twig-like Middle Cerebral Artery Presenting with Intracerebral Hemorrhage

Abstract: Author (year) Case Age /Sex Side Clinical presentation Angiographic finding of M1 Aneurysm Cerebral blood flow Treatment Intraoperative or pathological findings Outcome (hemorrhage) (M1-lesion)

Cited by 5 publications

References 17 publications

Twig-like middle cerebral artery as a variety of isolated middle cerebral artery disease with new vessel formation: illustrative case

Twig-like middle cerebral artery as a variety of isolated middle cerebral artery disease with new vessel formation: illustrative case

De novo formation of twig-like middle cerebral artery: An illustrative case

Twig-like middle cerebral arteries: Clinical and radiological findings

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