Background
An unfused or twiglike middle cerebral artery (MCA) is a congenital anomaly related
to the abnormal development of the MCA. An unfused or twiglike MCA can cause both
ischemic and hemorrhagic strokes. Previous reports have shown that an unfused or twiglike
MCA with coexisting aneurysms can cause subarachnoid hemorrhage (SAH).
Cases
Two patients presented with nonaneurysmal SAH due to an unfused or twiglike MCA. Both
patients had stenosis of the proximal M1 segment of the left MCA and abnormal vascular
nets distal to the stenotic lesion. Vasculature distal to the abnormal vascular nets
remained grossly normal. These findings were not evident in computed tomography or
magnetic resonance angiography.
Conclusion
An unfused or twiglike MCA can cause nonaneurysmal SAH. Digital subtraction angiography
is necessary for accurate diagnosis.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Endovascular treatment of an anterior cerebral artery aneurysm in a patient with embryonic unfused middle cerebral artery anomaly: a case report.Neuroradiology. 2005; 47: 690-694
- Aneurysms in twig-like middle cerebral artery.Cerebrovasc Dis. 2005; 20: 1-5
- Aneurysms associated with non-moyamoya collateral unfused arterial networks: report of three cases and review of literature.Neurosurg Rev. 2011; 34: 517-522
- Clinical and radiological features of patients with aplastic or twiglike middle cerebral arteries.Neurosurgery. 2012; 70: 1472-1480
- Flow-related intracranial aneurysms associated with unfused arterial twigs relevant to different vascular anomalies: embryonic and hemodynamic considerations.Acta Neurochir (Wien). 2014; 156: 1637-1646
- Unfused or twig-like middle cerebral artery.Eur J Radiol. 2015; 84: 2013-2018
- Moyamoya disease—a review.Stroke. 1983; 14: 104
- Middle cerebral artery dissection presenting with intracerebral and subarachnoid hemorrhage.J Case Rep. 2013; 3: 451-454
Article info
Publication history
Published online: April 08, 2016
Accepted:
March 15,
2016
Received in revised form:
February 23,
2016
Received:
December 16,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.03.029
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
