Document Detail

Clinical and radiological features of patients with aplastic or twiglike middle cerebral arteries.
MedLine Citation:
PMID:  22186843     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An aplastic or twiglike middle cerebral artery (Ap/T-MCA) is an extremely rare congenital anomaly related to interference in the normal embryonic development of the MCA.
OBJECTIVE: To evaluate the clinical and radiological features of patients with an Ap/T-MCA.
METHODS: A total of 1749 conventional cerebral angiography procedures were performed in 1282 patients from January 2005 to July 2011 at Daegu Fatima Hospital. The images were evaluated for cerebral arterial anomalies. The radiological features of an Ap/T-MCA, coexisting anomalies, and clinical manifestations were recorded. These prospectively maintained databases were analyzed retrospectively.
RESULTS: Ap/T-MCAs were found in 15 patients (1.17% angiographic incidence). The anomalies were confined to unilateral M1 segment, and no stenoses were seen in the adjacent major arteries. Of 15 patients, 6 (40%) had hemorrhagic strokes, 5 (33.3%) had ischemic strokes, and 4 (26.7%) had no symptoms. Aneurysms were found in 5 patients (33.3%). Coexisting cerebral arterial anomalies were seen in 12 patients (80%). Ten patients underwent conservative treatments, and the remaining 5 underwent surgical treatments, such as hematoma aspiration, indirect revascularization, and clipping or coiling of aneurysms.
CONCLUSION: An Ap/T-MCA is a rare anomaly and should be differentiated from moyamoya conditions and degenerative steno-occlusive diseases of the middle cerebral artery. Coexisting anomalies of the anterior or middle cerebral arteries are frequent. This anomaly is vulnerable to both hemorrhagic and ischemic strokes.
Byung-Sun Seo; Yoon-Soo Lee; Hyuk-Gee Lee; Jeong-Ho Lee; Kee-Young Ryu; Dong-Gee Kang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  70     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-18     Completed Date:  2012-09-10     Revised Date:  2012-09-18    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1472-80; discussion 1480     Citation Subset:  IM    
Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Republic of Korea.
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MeSH Terms
Cerebral Angiography
Cerebral Revascularization
Intracranial Arterial Diseases / complications,  epidemiology*,  pathology*
Middle Aged
Middle Cerebral Artery / abnormalities*,  radiography*,  surgery
Stroke / etiology
Young Adult
Comment In:
Neurosurgery. 2012 Aug;71(2):E522; author reply E522-3   [PMID:  22513842 ]

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