Jeong Seul-Ki, Kwak Hyo-Sung, Cho Young-Il
Department of Neurology & Research Institute of Clinical Medicine, Chonbuk National University Medical School & Hospital, San 2-20, Geumam-dong, Deokjin-gu, Jeonju, Chonbuk, South Korea (561-180).
J Neurol Sci. 2008 Dec 15;275(1-2):181-4. doi: 10.1016/j.jns.2008.07.037. Epub 2008 Sep 17.
We report five cases of middle cerebral artery (MCA) fenestration that might have caused cerebral infarction or ischemia.
Unilateral fenestration of the MCA was observed in five patients with artery-relevant cerebral infarction or ischemia. Enhanced magnetic resonance imaging (MRI) and three-dimensional MR angiography (MRA) were performed in the patients, and a division of the lumen after fenestration was observed using virtual arterial endoscopy. In one patient, MRA and virtual endoscopy showed an obstruction in one limb of the fenestration. The MCA fenestrations were observed in the proximal portion in three cases and the intermediate portion in two cases, and there was no associated aneurysm near or far from the fenestration.
The five patients underwent both contrast-enhanced magnetic resonance imaging (MRI) and 3D MRA. Virtual arterial endoscopy was then performed to visualize the division of the lumen, a landmark of fenestration.
The association between cerebral ischemia and MCA fenestration in the five cases suggests that the fenestration disturbing local flow hemodynamics seems to cause cerebral ischemia, even a direct causative relationship should be elucidated further.
我们报告了5例可能导致脑梗死或缺血的大脑中动脉（MCA）开窗畸形病例。
在5例与动脉相关的脑梗死或缺血患者中观察到MCA单侧开窗畸形。对这些患者进行了增强磁共振成像（MRI）和三维磁共振血管造影（MRA）检查，并使用虚拟动脉内窥镜观察到开窗后管腔的分隔情况。在1例患者中，MRA和虚拟内窥镜显示开窗的一个分支存在阻塞。3例患者的MCA开窗畸形位于近端部分，2例位于中间部分，开窗附近或远处均未发现相关动脉瘤。
5例患者均接受了对比增强磁共振成像（MRI）和三维MRA检查。然后进行虚拟动脉内窥镜检查，以观察管腔分隔情况，这是开窗畸形的一个标志。
这5例病例中脑缺血与MCA开窗畸形之间的关联表明，开窗畸形扰乱局部血流动力学似乎会导致脑缺血，尽管仍需进一步阐明直接的因果关系。
