Kajita Michihide, Yanaka Kiyoyuki, Hanai Sho, Aiyama Hitoshi, Takahashi Nobuyuki, Saiki Shinji, Ishikawa Eiichi
Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan.
Department of Radiology, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan.
Surg Neurol Int. 2023 Jun 2;14:192. doi: 10.25259/SNI_274_2023. eCollection 2023.
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 formation exist. Here, we report the first case describing possible T-MCA formation.
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 T-MCA.
This is the first case report describing possible T-MCA formation. Although a detailed laboratory examination did not confirm the etiology, autoimmune disease was suspected to have precipitated this vascular lesion.
树枝状大脑中动脉（T-MCA）是一种罕见的血管异常，其特征是大脑中动脉（MCA）的M1段被小血管的丛状动脉网络所取代。T-MCA通常被认为是一种胚胎学上的残留。相反，T-MCA也可能是继发性后遗症，但目前尚无关于其形成病例的报道。在此，我们报告首例描述可能的T-MCA形成的病例。
一名41岁女性因短暂性左半身轻瘫从附近诊所转诊至我院。磁共振（MR）成像显示双侧MCA轻度狭窄。此后患者每年接受一次MR成像随访。53岁时的MR成像显示右侧M1段闭塞。脑血管造影显示右侧M1段闭塞，并在闭塞部位形成了一个丛状网络，从而诊断为T-MCA。
这是首例描述可能的T-MCA形成的病例报告。尽管详细的实验室检查未证实病因，但怀疑自身免疫性疾病促成了这一血管病变。
