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Aplastic or Twiglike Middle Cerebral Artery with Contralateral Middle Cerebral Artery Stenosis Showing Transient Ischemic Attack: Illustrative Case by Hayato Takeda; Kiyoyuki Yanaka; Kuniyuki Onuma; Kazuhiro Nakamura; Kazuhiro Ishii; Eiichi Ishikawa is a Medicine article available to read on EtoBox.

What is Aplastic or Twiglike Middle Cerebral Artery with Contralateral Middle Cerebral Artery Stenosis Showing Transient Ischemic Attack: Illustrative Case about?

## BACKGROUND Aplastic or twiglike middle cerebral artery (Ap/T-MCA) is a rare anomaly characterized by a unilateral MCA occlusion with plexiform vessels that causes hemorrhagic and (less commonly) ischemic strokes. The reasons for this are rarely discussed, and thus optimal treatment for ischemic Ap/T-MCA remains controversial. Here, the authors report a case of Ap/T-MCA with transient ischemic attacks treated by bypass surgery and discuss the mechanism of ischemic development and treatment methods. ## OBSERVATIONS A 62-year-old hypertensive man with transient, recurrent left hemiparesis visited the authors’ hospital. Magnetic resonance angiography showed proximal occlusion of the right MCA and stenosis in the left MCA. Digital subtraction angiography revealed occlusion of the right MCA and abnormal vascular networks, leading to a diagnosis of Ap/T-MCA with contralateral MCA stenosis. Antiplatelet therapy with aspirin was insufficient, and a superficial temporal artery–MCA bypass was performed. There were no ischemic or hemorrhagic events postoperatively. ## LESSONS Atherosclerosis seems to have a significant impact on the development of ischemic stroke in patients with Ap/T-MCA,

Who reads Aplastic or Twiglike Middle Cerebral Artery with Contralateral Middle Cerebral Artery Stenosis Showing Transient Ischemic Attack: Illustrative Case?

Author

Hayato Takeda; Kiyoyuki Yanaka; Kuniyuki Onuma; Kazuhiro Nakamura; Kazuhiro Ishii; Eiichi Ishikawa

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Published

2022

Language

EN

Field

Medicine (Health Sciences)