{"id":"7d165c23-bcf3-44bf-be18-9c571d792362","slug":"de-novo-formation-of-twig-like-middle-cerebral-artery-an-illustrative-case","title":"<i>De novo</i> formation of twig-like middle cerebral artery: An illustrative case","authors":["Michihide Kajita","Kiyoyuki Yanaka","Sho Hanai","Hitoshi Aiyama","Nobuyuki Takahashi","Shinji Saiki","Eiichi Ishikawa"],"abstract":"Background: Twig-like middle cerebral artery (T-MCA) is a rare vascular abnormality characterized by the replacement of the M1 segment of the middle cerebral artery (MCA) with a plexiform arterial network of small vessels. T-MCA is generally regarded as an embryological persistence. Conversely, T-MCA may also be a secondary sequela but no reports of cases of de novo formation exist. Here, we report the first case describing possible de novo T-MCA formation. Case Description: A 41-year-old woman was referred to our hospital from a nearby clinic because of transient left hemiparesis. Magnetic resonance (MR) imaging revealed mild stenosis of the bilateral MCAs. The patient then underwent MR imaging follow-ups once a year. MR imaging at the age of 53 showed a right M1 occlusion. Cerebral angiography revealed a right M1 occlusion and formation of a plexiform network consistent with the occlusion site, leading to the diagnosis of de novo T-MCA. Conclusion: This is the first case report describing possible de novo T-MCA formation. Although a detailed laboratory examination did not confirm the etiology, autoimmune disease was suspected to have precipitated this vascular lesion.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/7d165c23-bcf3-44bf-be18-9c571d792362/featured/hero-1781560280970.png","publishDate":"2023-06-02T00:00:00.000Z","doi":"10.25259/SNI_274_2023","categories":["Neurovascular","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/7d165c23-bcf3-44bf-be18-9c571d792362/pdf"}