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CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardioneurology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1530241
This article is part of the Research Topic Case Reports in Cardioneurology: 2024 View all articles
Twig-like Middle Cerebral Artery: A Case Report and Literature Review
Provisionally accepted- 1 The Department of Neurology, Hebei Provincial People's Hospital, Shijiazhuang, China
- 2 The Department of Neurointervention, Hebei Provincial People's Hospital, Shijiazhuang, China
- 3 The Department of Neurology, Hebei Provincial People's Hospital, Shijiazhuang, China
Background: Twig-like middle cerebral artery (T-MCA) is a rare cerebrovascular malformation with an incidence of approximately 0.11% to 1.17%. It is challenging to distinguish T-MCA from Moyamoya Angiopathy (MMA), particularly from unilateral MMA.Case presentation: A middle-aged female patient was admitted to our hospital for diagnosis and treatment due to intermittent dizziness lasting for two months. Neurological examination upon admission revealed no significant abnormalities.Whole-brain angiography showed clear blood flow in the left common carotid artery and internal carotid artery; however, no main trunk of the distal left middle cerebral artery M1 segment was visualized, and a network of small arteries supplying blood was observed. High-resolution intracranial arterial plaque imaging revealed no visualization of the LM1 main trunk on plain scan or enhanced high-resolution black-blood sequence; the proximal segment showed significant narrowing with circumferential thickening of the vessel wall. The patient was ultimately diagnosed with left-sided T-MCA.Asymptomatic T-MCA is challenging to identify clinically, making it essential to perform DSA or high-resolution MRI for suspected cases promptly. Regular follow-up is also necessary to confirm the final diagnosis in these patients.
Keywords: Twig-like middle cerebral artery, Cerebrovascular angiography, Neuroimaging, Pathogenesis, differential diagnosis, Clinical manifestation 2 Twig-like Middle Cerebral Artery: A Case Report and Literature Review Twig-like middle cerebral artery, Clinical manifestation
Received: 19 Dec 2024; Accepted: 18 Feb 2025.
Copyright: © 2025 Wang, Xie, Xu, Yao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hebo Wang, The Department of Neurology, Hebei Provincial People's Hospital, Shijiazhuang, China
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