Management of Aneurysms at the Origin of Duplicated Middle Cerebral Artery: Series of Four Patients with Review of the Literature

Elsharkawy, Ahmed; Ishii, Keisuke; Niemelä, Mika; Kivisaari, Riku; Lehto, Hanna; Hernesniemi, Juha

doi:10.1016/j.wneu.2012.10.004

Cited by 23 publications

(17 citation statements)

References 20 publications

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“…Selected authors noted an association between duplicated MCAs and aneurysms (50,61,62), although very few studies have reported aneurysms at the origin or near the anomalous branch (12,24,29,42,49,57,70). Several authors observed an association between accessory MCAs and aneurysms (30,80,91).…”

Section: Cortical Branchesmentioning

confidence: 99%

Review on the anatomy of the middle cerebral artery; cortical branches, branching pattern and anomalies

Cilliers¹,

Page²

2016

Turkish Neurosurgery

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The middle cerebral artery (MCA) covers a large part of the cerebral hemispheres and is therefore exposed during surgical intervention in this area. Aspects of cerebral branches tend to vary, different branching patterns can be described, and several anomalies can be observed. Knowledge of these variations and anomalies is important and can be helpful to neurosurgeons and clinicians. The aim of this manuscript was to review the available literature on the cortical branches, branching pattern and anomalies of the MCA, to identify the gaps in the literature, and to fill these gaps by including the results of a pilot study. Twenty hemispheres were perfused with colored silicone and the MCA was dissected. For the cortical branches, the diameter, length, presence, duplication and origins were noted. Most commonly duplicated was the anterior parietal artery in 30.0%, and most commonly absent was the common temporal artery in 65.0%. A detailed description on the origins is given. Criteria were described for the bifurcation subtypes and medial bifurcation (50.0%) was most commonly observed. No anomalies were observed. Aspects previously neglected of the MCA cortical branches were reported in the pilot study. The branching subtypes were identified and criteria are given. Illustrations of the different branching subtypes and anomalies are provided. Certain aspects of the MCA anatomy have been neglected, and future studies should give adequate descriptions of the MCA cortical branches, MCA branching pattern, and any anomalies observed.

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Section: Cortical Branchesmentioning

confidence: 99%

Review on the anatomy of the middle cerebral artery; cortical branches, branching pattern and anomalies

Cilliers¹,

Page²

2016

Turkish Neurosurgery

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“…The reported frequency of MCA duplication is 0.2-2.9% for that of the accessory MCA, which is 0.3-4.0%. 3) 4) 9) Even on autopsy series they are found less than 3% of the time, and on cerebral angiography, the frequency is 1-1.5%.…”

Section: Discussionmentioning

confidence: 99%

An Unruptured Cerebral Aneurysm at the Origin of the Duplicated Middle Cerebral Artery

Kim

Lee

Park

et al. 2015

J Cerebrovasc Endovasc Neurosurg

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A variety of cerebral vascular anomalies are widely applied, however anomalies of the middle cerebral artery (MCA) are relatively infrequent. The duplicated MCA (DMCA) is a MCA anomaly. Aneurysm arising from the origin of the DMCA is rare. Cerebral angiography in a 61-year-old female demonstrated a small (about 3 mm) saccular aneurysm located at the origin of the DMCA in the anterior direction. Considering the unusual location, the lesion was treated, regardless of the size. Aneurysmal characteristics of a broad neck and small size limited the endovascular approach, necessitating open surgery. Her postoperative course was uneventful and postoperative angiography showed complete obliteration of the aneurysm. The patient was discharged without neurologic deficit.

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“…1) Some patients with excess blood vessels develop cerebral aneurysms, but DMCA aneurysms arising at its origin are rare, although their incidence remains to be clarified. In all, 11 patients with unruptured aneurysms at the origin, [2][3][4][5][6][7][8][9] including an autopsy case reported by Crompton et al 1) have been reported. The 12 patients, including the present case, are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding unruptured aneurysms, only 11 patients have been reported. [2][3][4][5][6][7][8][9] In 9 of the 11 patients, clipping during craniotomy was performed, and the other two underwent conservative treatment due to small aneurysms.…”

Section: Introductionmentioning

confidence: 99%

A Patient with an Unruptured Aneurysm in the Internal Carotid Artery-duplicated Middle Cerebral Artery on Whom Coil Embolization with Balloon Remodeling Was Performed

Suzuki

Takigawa

Anazawa

et al. 2020

JNET

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Treatment of an unruptured aneurysm at the origin of duplicated middle cerebral artery (DMCA) by coil embolization using balloon remodeling has not been reported. We report a case of coil embolization using balloon remodeling for an unruptured aneurysm at the origin of DMCA. Case Presentation: A 71-year-old female was found to have an unruptured aneurysm at the origin of DMCA during an examination for headache. Coil embolization using balloon remodeling for the wide neck aneurysm to preserve both the internal carotid artery (ICA) and DMCA was successful. The perioperative course was uneventful. Conclusion: This treatment enables complete embolization, and preserves both the ICA and DMCA. Thus, it is useful for aneurysms at the origin of DMCA. Keywords▶ duplication of middle cerebral artery, cerebral unruptured aneurysm, coil embolization, balloon remodeling This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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Management of Aneurysms at the Origin of Duplicated Middle Cerebral Artery: Series of Four Patients with Review of the Literature

Cited by 23 publications

References 20 publications

Review on the anatomy of the middle cerebral artery; cortical branches, branching pattern and anomalies

Review on the anatomy of the middle cerebral artery; cortical branches, branching pattern and anomalies

An Unruptured Cerebral Aneurysm at the Origin of the Duplicated Middle Cerebral Artery

A Patient with an Unruptured Aneurysm in the Internal Carotid Artery-duplicated Middle Cerebral Artery on Whom Coil Embolization with Balloon Remodeling Was Performed

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