Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
BMJ Case Rep. 2021 Feb 1;14(2):e240219. doi: 10.1136/bcr-2020-240219.
Haemodynamic flow-related stress at the vessel curvatures is an important risk factor for intracranial aneurysmal growth and rupture. The rete middle cerebral artery (MCA) is a rare entity causing hyperdynamic blood flow into the ipsilateral anterior cerebral artery (ACA), especially when the contralateral A1-segment is non-dominant. Ruling out the clinicoradiological mimics like vasculitis, moyamoya and chronic occlusive disease with vessel wall imaging and detailed investigations helps manage the clinical entity effectively. We present a successfully managed case of ruptured ACA aneurysm at the acute curvature of the A1-A2 junction associated with ipsilateral rete MCA. Pre-emptive diagnosis of the rete MCA can aid preventive strategies to manage rupture and regrowth of the aneurysm at the points of flow-related stress.
血管弯曲处与血流相关的压力是颅内动脉瘤生长和破裂的一个重要危险因素。大脑中动脉（MCA）吻合是一种罕见的解剖变异，可导致血流异常进入对侧大脑前动脉（ACA），尤其是当对侧 A1 段为非优势侧时。通过血管壁成像和详细的检查排除血管炎、烟雾病和慢性闭塞性疾病等类似的临床和影像学表现，有助于有效地管理这种临床实体。我们报告了一例成功治疗的破裂的 ACA 动脉瘤病例，该动脉瘤位于 A1-A2 交界处的急性弯曲处，同侧存在 MCA 吻合。对 MCA 吻合的预防性诊断可以为管理与血流相关的压力点处的动脉瘤破裂和再生长提供预防策略。
