Twig-like Middle Cerebral Artery : Case Series in a European Population
Copyright © 2023 Elsevier Inc. All rights reserved..
OBJECTIVES: Twig-like middle cerebral artery (MCA) is a rare anomaly where the M1 MCA is partially or completely replaced by a plexiform network. It has been described in angiographic series from Asian and South-American cohorts, but has not yet been reported in a European population.
METHODS: The digital subtraction angiograms (DSAs) of adult patients referred to a single neurovascular center for a diagnostic hypothesis of moyamoya arteriopathy (MMA) from 2018 to 2023 were prospectively and retrospectively checked by experienced neuroradiologists for identifying patients with twig-like MCA. The angioarchitecture of twig-like MCA was systematically evaluated and described.
RESULTS: Five of 30 (16.7%) male patients (mean age 55.8 + 14.7 years) of European ancestry were identified as having twig-like MCA. The clinical presentations were ischemic stroke (2 of 5), hemorrhagic stroke (1 of 5), and headache (2 of 5). All patients showed a unilateral involvement on DSA and in 1 of 5 (20%) an intracranial aneurysm was found. DSA was used to confirm the diagnosis of twig-like MCA and define the angioarchitecture and associated anomalies. An accessory MCA and recurrent artery of Heubner were found in 3 of 5 (60%) cases, feeding the network together with the anterior choroidal artery (4 of 5, 80%).
CONCLUSIONS: Twig-like MCA is a rare vascular anomaly, but it seems to be less rare than expected among adult European patients with suspected MMA on noninvasive neuroimaging studies. DSA is fundamental for a reliable differential diagnosis and should not be omitted in these patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:183 |
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| Enthalten in: |
World neurosurgery - 183(2024) vom: 07. März, Seite e11-e21 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zedde, Marialuisa [VerfasserIn] |
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| Links: |
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| Themen: |
3D-RA |
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| Anmerkungen: |
Date Completed 13.03.2024 Date Revised 13.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.wneu.2023.09.121 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363001107 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: Twig-like middle cerebral artery (MCA) is a rare anomaly where the M1 MCA is partially or completely replaced by a plexiform network. It has been described in angiographic series from Asian and South-American cohorts, but has not yet been reported in a European population | ||
| 520 | |a METHODS: The digital subtraction angiograms (DSAs) of adult patients referred to a single neurovascular center for a diagnostic hypothesis of moyamoya arteriopathy (MMA) from 2018 to 2023 were prospectively and retrospectively checked by experienced neuroradiologists for identifying patients with twig-like MCA. The angioarchitecture of twig-like MCA was systematically evaluated and described | ||
| 520 | |a RESULTS: Five of 30 (16.7%) male patients (mean age 55.8 + 14.7 years) of European ancestry were identified as having twig-like MCA. The clinical presentations were ischemic stroke (2 of 5), hemorrhagic stroke (1 of 5), and headache (2 of 5). All patients showed a unilateral involvement on DSA and in 1 of 5 (20%) an intracranial aneurysm was found. DSA was used to confirm the diagnosis of twig-like MCA and define the angioarchitecture and associated anomalies. An accessory MCA and recurrent artery of Heubner were found in 3 of 5 (60%) cases, feeding the network together with the anterior choroidal artery (4 of 5, 80%) | ||
| 520 | |a CONCLUSIONS: Twig-like MCA is a rare vascular anomaly, but it seems to be less rare than expected among adult European patients with suspected MMA on noninvasive neuroimaging studies. DSA is fundamental for a reliable differential diagnosis and should not be omitted in these patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a 3D-RA | |
| 650 | 4 | |a Anterior choroidal artery | |
| 650 | 4 | |a DSA | |
| 650 | 4 | |a Moyamoya arteriopathy | |
| 650 | 4 | |a Recurrent artery of heubner | |
| 650 | 4 | |a Twig-like MCA | |
| 700 | 1 | |a Moratti, Claudio |e verfasserin |4 aut | |
| 700 | 1 | |a Pavone, Claudio |e verfasserin |4 aut | |
| 700 | 1 | |a Napoli, Manuela |e verfasserin |4 aut | |
| 700 | 1 | |a Valzania, Franco |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Thanh N |e verfasserin |4 aut | |
| 700 | 1 | |a Abdalkader, Mohamad |e verfasserin |4 aut | |
| 700 | 1 | |a Pascarella, Rosario |e verfasserin |4 aut | |
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