Unfused or twig-like middle cerebral artery

Akkan, Koray; Uçar, Murat; Kılıç, Koray; Çeltikçi, Emrah; Ilgıt, Erhan; Önal, Baran

doi:10.1016/j.ejrad.2015.06.012

Cited by 38 publications

(44 citation statements)

References 16 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of twiglike MCA is about 0.11% (2/1814) according to Liu et al 15 Akkan et al reported their experience of unfused or twiglike MCA with an incidence of 0.13% (6/4372) in their series. 1 The highest frequency of aplastic or twiglike MCA was 1.17% (15/1282) reported by Seo et al 25 In our study, the prevalence of rete MCA was 0.67% (13/1937) by angiographic examination. This prevalence is lower than that of the other MCA anomalies.…”

Section: Prevalencesupporting

confidence: 45%

See 1 more Smart Citation

Rete middle cerebral artery anomalies: a unifying name, case series, and literature review

Cho

Kim

Jang

et al. 2019

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVE Rete middle cerebral artery (MCA) is extremely rare and has not been frequently discussed. Rete MCA is a weblike anomaly of the MCA that does not coalesce and forms a prominent, large single branch from the plexiform vessels in the fetal stage. The purpose of this study was to further elucidate the clinical and radiological characteristics of patients with rete MCA. METHODS A total of 2262 cerebral digital subtraction angiography procedures were performed on 1937 patients at the authors' institution from February 2013 to May 2017. Data analysis included age, sex, clinical symptoms, underlying diseases, coexisting cerebral arterial anomalies, and operative methods and findings. RESULTS Rete MCAs were found in 13 patients, and the incidence of this anomaly was 0.67% (13 of 1937) in this study. Of the 13 patients, 3 had hemorrhagic strokes, 6 had ischemic strokes, and 4 had no symptoms. Eight patients underwent conservative treatment, and 5 patients underwent surgical treatment. Rete MCA is considered a congenital disease of the cerebral vasculature with the possibility of an acquired abnormality, such as an aneurysm, caused by hemodynamic stress. Although an epidemiological survey of rete MCA was not conducted, it is assumed that rete MCA has a high prevalence in Asia. Ischemic and hemorrhagic stroke events are fairly common in rete MCA. CONCLUSIONS Clinicians should understand the radiological and clinical features of patients with rete MCA to avoid misdiagnosis and unnecessary treatment. This anomaly should be differentiated from other vascular diseases and patients presenting incidentally should be carefully monitored because of their vulnerability to both hemorrhagic and ischemic strokes.

show abstract

Section: Prevalencesupporting

confidence: 45%

“…The pathogenesis of rete MCA is not well known yet. Many authors described rete MCA as a congenital anomaly resulting from a fusion interference of the main trunk of the MCA in the embryonic development stage 1,3,15,22,25,26 ( Fig. 4).…”

Section: Pathogenesis (Congenital Versus Acquired)mentioning

confidence: 99%

Rete middle cerebral artery anomalies: a unifying name, case series, and literature review

Cho

Kim

Jang

et al. 2019

Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…10) Recently, Shin et al reported four cases, 11) and Akkan et al reported six cases. 12) Common angiographical features of these cases were as follows; 1) a steno-occlusive lesion can be seen on the unilateral MCA, 2) plexiform arterial network exists instead of the main MCA trunk, 3) perforators arise from the plexiform arterial network, and 4) cortical branches beyond the occluded MCA trunk have anterograde flow with normal configuration. Although almost half the cases presented with intracranial hemorrhage, few cases were found incidentally.…”

Section: Anomalies Of the Mcamentioning

confidence: 97%

“…6) In the twig-like MCA anomaly, there is no MCA trunk, but a twig-like arterial network instead. 8–12) …”

Section: Anomalies Of the Mcamentioning

confidence: 99%

See 1 more Smart Citation

Anomalies of the Middle Cerebral Artery

Uchiyama

2017

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

There are several anomalies of the middle cerebral artery (MCA) in humans, such as accessory MCA, duplicated MCA, fenestration of MCA, and duplicated origin of MCA. Recently, unfused or twig-like MCA, which indicates MCA trunk occlusion with collateral plexiform arterial network, have been reported. During the embryonic stage, MCA is thought to generate from plexiform arterial twigs arising from the anterior cerebral artery, and these twigs form the definitive MCA by fusion and regression at the end of the development stage. Any interruption during the fusion of the arterial twigs may result in MCA anomalies, and the unfused or twig-like MCA, especially, is hypothesized to be the persistent primitive arterial twigs. Clinically, it is challenging to differentiate the unfused or twig-like MCA from unilateral moyamoya disease, in which stenotic change begins at the MCA. The knowledge of the anomalies of the MCA is important to perform a safe surgical or endovascular intervention.

show abstract