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2021, vol. 149, br. 11-12, str. 722-724
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Asimptomatska embriološka anomalija srednje cerebralne arterije "nalik grančici"
Asymptomatic 'twig-like' middle cerebral artery embryological anomaly
aKlinički centar Srbije, Centar za radiologiju i magnetnu rezonancu, Beograd, Srbija bKlinički centar Srbije, Klinika za neurohirurgiju, Beograd, Srbija + Univerzitet u Beogradu, Medicinski fakultet, Srbija cKlinički centar Srbije, Centar za radiologiju i magnetnu rezonancu, Beograd, Srbija + Univerzitet u Beogradu, Medicinski fakultet, Srbija
e-adresa: i.m.nikolic@gmail.com
Ključne reči: CMA "nalik grančici"; srednja moždana arterija; kopjuterizovana tomografska angiografija
Sažetak
Uvod Anomalije srednje moždane arterije (CMA) veoma su retke. Rete MCA, twig-like MCA (T-MCA), "aplastična CMA", "nefuzionisana CMA" i drugi nazivi sinonimi su za jednostranu embrionalnu anomaliju segmenta M1 CMA, gde, iz nepoznatih razloga, nije došlo do fuzije primordijalnih arterija segmenta M1. Kao rezultat, segment M1 zahvaćene strane sastoji se iz mreže malih arterija iz koje polaze normalni perforatori i kortikalne grane. Diferencijalno dijagnostički treba razmatrati bolest mojamoja, sindrom sličan mojamoji, aterosklerotičnu stenookluzivnu bolest, vaskulitis i disekciju CMA. Prikaz bolesnika Prikazujemo ženu staru 60 godina sa CMA "nalik grančici", slučajno otkrivenoj zbog perzistentnih glavobolja šest dana pre prijema. Beckontrastna kompjuterizovana tomografija glave nije pokazala neuobičajenosti. Kopjuterizovana tomografska angiografija prikazala je mrežu malih krvnih sudova umesto levog segmenta M1, koja je povezivala terminalni segment unutrašnje karotidne arterije sa granama bifurkacije CMA i lentikulostrijatnim arterijama. Četrnaest meseci kasnije, na kontrolnom fizikalnom pregledu, bolesnica je bila dobrog opšteg stanja, bez neurološkog deficita, sa povremenim epizodama glavobolje ne jačim od 3-4/10 na vizuelnoj analognoj skali. Zaključak Prikazujemo bolesnicu sa ekstremno retkom varijacijom levog segmenta M1 CMA, slučajno otkrivenom zbog upornih glavobolja.
Abstract
Introduction Anomalies of the middle cerebral artery (MCA) are very rare. "Rete MCA," "twig-like MCA" (T-MCA), "aplastic MCA," "unfused MCA," and others are all synonyms for unilateral embryological anomaly of the M1 segment of the MCA, where, due to an unknown cause, fusion of primordial arteries of the M1 segment did not happen. As a result, the M1 segment of the affected side consists of a mesh of small arteries from which arise normal perforators and cortical branches. Moyamoya disease, moyamoya-like syndrome, atherosclerotic steno-occlusive disease, vasculitis, and dissection of the MCA should be considered in differential diagnosis. Case outline We present a 60-year-old female patient with twig-like left MCA, incidentally diagnosed due to persistent headaches six days prior to admission. Non-contrast computed tomography head examination was without peculiarities. Computed tomography angiography showed a network of small vessels in place of the left M1 segment, bridging internal carotid artery terminus with branches of the MCA bifurcation and giving rise to lenticulostriate arteries. Fourteen months later, on physical examination, the patient was in good general condition, without a neurological deficit, with occasional episodes of headache no stronger than 3-4/10 on the visual analogue scale. Conclusion We report a patient with extremely rare variation of the M1 segment of the left MCA, incidentally diagnosed due to headaches.
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Reference
|
|
  
|
Akkan, K., Ucar, M., Kilic, K., Celtikci, E., Ilgit, E., Onal, B. (2015) Unfused or twig-like middle cerebral artery. European Journal of Radiology, 84(10): 2013-2018
|
|
|
Cho, K.C., Kim, J.J., Jang, C.K., Hong, C.K., Joo, J.Y., Kim, Y.B. (2019) Rete middle cerebral artery anomalies: a unifying name, case series, and literature review. Journal of Neurosurgery, 131(2): 453-461
|
|
|
Cilliers, K., Page, B.J. (2017) Review on the anatomy of the middle cerebral artery; cortical branches, branching pattern and anomalies. Turk Neurosurg, 27(5): 671-81
|
|
|
Fukuyama, R., Yamamura, K., Murata, H., Miyatake, S., Matsumoto, N., Abe, H. (2020) Ruptured Aneurysm of an Aplastic or Twig-like Middle Cerebral Artery with Ring Finger Protein 213 Mutation: A Case Report. No Shinkei Geka, 48(6): 533-40, Article in Japanese
|
|
|
Goto, Y., Oka, H., Hiraizumi, S., Okamoto, T., Nishii, S., Yamamoto, H., et al. (2019) Aplastic or Twig-Like Middle Cerebral Artery Presenting with Intracerebral Hemorrhage During Pregnancy: Report of Two Cases. World Neurosurgery: X, 2: 100018
|
|
|
Hosur, B., Bhatia, V., Kumar, A., Karthigeyan, M. (2021) Rete middle cerebral artery: a rare association with anterior cerebral artery aneurysm rupture. BMJ Case Reports, 14(2): e240219
|
|
|
Matsunaga, Y., Izumo, T., Morofuji, Y., Horie, N., Hayashi, K., Matsuo, T. (2018) Revascularization for Aplastic or Twiglike Middle Cerebral Artery: A Case Report. Journal of Stroke and Cerebrovascular Diseases, 27(5): e78-e79
|
|
|
Matsuo, A., Hiu, T., Ito, T., Moritsuka, T., Honda, K., Kawahara, I., et al. (2020) Aplastic or Twig-like Middle Cerebral Artery with Cortical Subarachnoid Hemorrhage and Reversible Cerebral Vasoconstriction Syndrome during the Postpartum Period in a Juvenile Female: A Case Report. No Shinkei Geka, 48(5): 435-44, Article in Japanese
|
|
|
Ren, H., Ma, L., Wei, M., Li, J., Yu, M., Yin, L. (2018) Duplicated middle cerebral artery origin with an aneurysm. Medicine (Baltimore), 97(9): e9947
|
|
|
Sakai, K., Hiu, T., Fukuda, Y., Ozono, K., Honda, K., Kawahara, I., et al. (2018) A Rare Case of a Ruptured De Novo Aneurysm Arising from the Twig-like Networks of an Anomalous Collateral Artery Associated with Hypoplasia of the M1 Segment of the Middle Cerebral Artery 4 Years after the Rupture of an A1 Aneurysm at the Origin of t. No Shinkei Geka, 46(8): 713-22, Article in Japanese
|
|
|
Seo, B.S., Lee, Y.S., Lee, H.G., Lee, J.H., Ryu, K.Y., Kang, D.G. (2012) Clinical and Radiological Features of Patients With Aplastic or Twiglike Middle Cerebral Arteries. Neurosurgery, 70(6): 1472-80, discussion 1480
|
|
|
Shin, H.S., Lee, S.W., Ryu, C.W., Koh, J.S. (2014) Flow-related intracranial aneurysms associated with unfused arterial twigs relevant to different vascular anomalies: embryologic and hemodynamic considerations. Acta Neurochir (Wien), 156(9): 1637-1646
|
|
|
Teofllovski-Parapid, G., Filipović, B., Marković, D., Obrenović, B., Janošević, S., Stanković, G., Matanović, D., Ranković, A., Blagotić, M. (2006) Arterial circle of the African green monkey brain. Acta veterinaria, vol. 56, br. 2-3, str. 225-234
|
|
|
Tsuyama, K., Myamoto, N., Shindo, A., Hira, K., Ueno, Y., Yatomi, K., et al. (2021) Analysis for Stroke Etiology in Duplicated/Accessory MCA-Related Cerebral Infarction: Two Case Report and Brief Literature Review. Diagnostics, 11(2): 205
|
|
|
Uchiyama, T., Okamoto, H., Koguchi, M., Tajima, Y., Suzuyama, K. (2016) A Case of Aplastic or Twig-Like Middle Cerebral Artery Presenting with an Intracranial Hemorrhage Two Years after a Transient Ischemic Attack. No Shinkei Geka, 44(2): 143-8
|
|
|
Viso, R., Lylyk, I., Albiña, P., Lundquist, J., Scrivano, E., Lylyk, P. (2021) Hemorrhagic events associated with unfused or twig-like configuration of the Middle cerebral artery: A rare vascular anomaly with clinical relevance. Interventional Neuroradiology, 27(2): 285-290
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