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CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 495-499
DOI: 10.1055/s-0042-1757215
Case Report

Cerebral Infarction Due to Occlusion of Main Trunk of Middle Cerebral Artery in Patient with Accessory Middle Cerebral Artery

Atsushi Tsuchiya
1   Department of Neurology, Kanto Rosai Hospital, Kawasaki, Japan
,
Atsushi Tsukiyama
2   Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki, Japan
,
Shutaro Matsumoto
2   Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki, Japan
,
Toshimasa Uekusa
3   Department of Pathology, Kanto Rosai Hospital, Kawasaki, Japan
,
Hiroyuki Abe
4   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Issei Fukui
4   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Yu Iida
4   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Kentaro Mori
4   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Yosuke Kawahara
4   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Akira Tamase
4   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Katsuya Abe
5   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Ryotaro Yamashita
5   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Mutsuki Takeda
5   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Tatsu Nakano
5   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Motohiro Nomura
2   Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki, Japan
4   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
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Abstract

The existence of an accessory middle cerebral artery (AMCA) usually has no pathological significance. Three patients developed cerebral infarction due to thromboembolic occlusion of the main trunk of the middle cerebral artery (MCA). In these patients, AMCA originating from the anterior cerebral artery was intact, and ran to the lateral side along the main MCA. Emergency endovascular treatment to remove the thrombus in the main MCA was performed, and MCA was recanalized. In one patient, the main MCA re-occluded and cerebral infarction developed on the next day. The diameter of AMCA is commonly smaller than that of the main MCA. Therefore, volume of ischemic region depends on the collateral blood flow to the left MCA territory by AMCA. Once an anomalous MCA is detected in a patient with cerebral infarction involving the MCA territory, close examinations to assess the anatomy of both the main and anomalous MCA are mandatory.

Keywords

anomaly - accessory - middle cerebral artery - cerebral infarction - thromboembolism


Publication History

Article published online:
08 October 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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