Publication year: 2011
Source: World Neurosurgery, Available online 19 November 2011
David V. LaBorde, Alexander M. Mason, Jonathan Riley, Jacques E. Dion, Daniel L. Barrow
BACKGROUNDAnatomic middle cerebral artery (MCA) anomalies are rare, but each of the described variants (eg, duplicate, fenestrated, accessory) can be of clinical significance.CASE DESCRIPTIONA 34-year-old man with a history of left hemispheric stroke was found to have an aberrant, early-arising duplicate left M1 segment of the MCA with an associated asymptomatic fusiform aneurysm. The patient was treated with a superficial temporal artery (STA) to distal MCA bypass followed by surgical trapping of the aneurysm.RESULTSIntraoperative and follow-up angiography performed postoperatively at 3 months showed complete isolation of the aneurysm from the circulation and patency of the bypass graft. The postoperative course was uneventful with the exception of a craniotomy flap infection, which was effectively managed with intravenous antibiotics, flap removal, and subsequent use of a fabricated replacement.CONCLUSIONSThis rare case is presented and used as a framework for a brief discussion of the literature regarding both variant MCA anatomy and treatment considerations for these anomalies when associated with an aneurysm.
Júlio Leonardo B. Pereira
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