Hosokawa Makoto, Maeoka Ryosuke, Nakagawa Ichiro, Nakase Hiroyuki, Ohnishi Hideyuki
Department of Neurosurgery, Ohnishi Neurologic Center, Akashi, Japan.
Department of Neurosurgery, Nara Medical University, Nara, Japan.
Radiol Case Rep. 2022 Mar 3;17(5):1483-1486. doi: 10.1016/j.radcr.2022.01.081. eCollection 2022 May.
Fenestration of the middle cerebral artery (MCA) is a rare anatomic variant, and lenticulostriate arteries (LSAs) often arise from the superior limb of the fenestrated segment. A case of acute occlusion of the superior limb of a fenestrated MCA that successfully underwent mechanical thrombectomy is presented. Digital subtraction angiography performed for a 73-year-old man with acute left hemiparesis showed poor visualization of the upper half of the right M1 segment with maintenance of antegrade peripheral circulation of the MCA territory, and mechanical thrombectomy was successfully performed using a stent retriever with intravenous thrombolysis. After restoration of the MCA, the vascular variant of a fenestrated MCA was found. Clinicians must consider the possibility of acute occlusion of a fenestrated MCA before endovascular thrombectomy. Restoration of acute occlusion of the upper limb of a fenestrated MCA can avoid LSA territory infarction.
大脑中动脉（MCA）开窗是一种罕见的解剖变异，豆纹动脉（LSA）常起自开窗段的上支。本文报道1例开窗型MCA上支急性闭塞且成功接受机械取栓治疗的病例。对一名73岁急性左半身轻瘫男性进行的数字减影血管造影显示，右侧M1段上半部分显影不佳，但MCA区域的顺行外周循环得以维持，并使用支架取栓器联合静脉溶栓成功实施了机械取栓。恢复MCA血流后，发现存在开窗型MCA这种血管变异。临床医生在进行血管内取栓术前必须考虑开窗型MCA急性闭塞的可能性。恢复开窗型MCA上支的急性闭塞可避免豆纹动脉区域梗死。
