Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery

Abstract Background The duplicated middle cerebral artery (DMCA), a rare anatomical variant of the middle cerebral artery, arises between the anterior choroidal artery and the distal end of the internal carotid artery. We present the case of a patient who had an acute progressive stroke caused by se...

Full description

Bibliographic Details
Main Authors: Lei Wang, Zhiyong Zhang
Format: Article
Language:English
Published: BMC 2023-11-01
Series:BMC Neurology
Subjects:
Online Access:https://doi.org/10.1186/s12883-023-03456-4
_version_ 1797452201791062016
author Lei Wang
Zhiyong Zhang
author_facet Lei Wang
Zhiyong Zhang
author_sort Lei Wang
collection DOAJ
description Abstract Background The duplicated middle cerebral artery (DMCA), a rare anatomical variant of the middle cerebral artery, arises between the anterior choroidal artery and the distal end of the internal carotid artery. We present the case of a patient who had an acute progressive stroke caused by severe stenosis in the initial segment of the DMCA and was successfully treated with endovascular stenting. Case presentation A 57-year-old man was admitted to our hospital with sudden left extremity weakness for three days. Cranial magnetic resonance imaging revealed multiple fresh infarcts in the right basal ganglia and temporal lobe. Cerebrovascular imaging revealed severe stenosis of the right DMCA’s initial segment. However, despite standard medical therapy, the patient’s limb weakness worsened. Based on the clinical and imaging findings, we speculated that severely stenotic DMCA is responsible for the acute progressive stroke. On the basis of the best medical treatment, the patient successfully underwent endovascular stent implantation under general anesthesia two weeks after the onset. The patient’s condition was stable after interventional therapy, and his postoperative follow-up prognosis was favorable. Conclusions Endovascular stenting may be a feasible treatment for symptomatic severe stenosis of the DMCA in cases of poor control with standard medications.
first_indexed 2024-03-09T15:05:21Z
format Article
id doaj.art-d9242f4dabd140cab5d47342cf4e9315
institution Directory Open Access Journal
issn 1471-2377
language English
last_indexed 2024-03-09T15:05:21Z
publishDate 2023-11-01
publisher BMC
record_format Article
series BMC Neurology
spelling doaj.art-d9242f4dabd140cab5d47342cf4e93152023-11-26T13:42:04ZengBMCBMC Neurology1471-23772023-11-012311510.1186/s12883-023-03456-4Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral arteryLei Wang0Zhiyong Zhang1Department of Neurology, Beijing Geriatric HospitalDepartment of Neurology, Beijing Geriatric HospitalAbstract Background The duplicated middle cerebral artery (DMCA), a rare anatomical variant of the middle cerebral artery, arises between the anterior choroidal artery and the distal end of the internal carotid artery. We present the case of a patient who had an acute progressive stroke caused by severe stenosis in the initial segment of the DMCA and was successfully treated with endovascular stenting. Case presentation A 57-year-old man was admitted to our hospital with sudden left extremity weakness for three days. Cranial magnetic resonance imaging revealed multiple fresh infarcts in the right basal ganglia and temporal lobe. Cerebrovascular imaging revealed severe stenosis of the right DMCA’s initial segment. However, despite standard medical therapy, the patient’s limb weakness worsened. Based on the clinical and imaging findings, we speculated that severely stenotic DMCA is responsible for the acute progressive stroke. On the basis of the best medical treatment, the patient successfully underwent endovascular stent implantation under general anesthesia two weeks after the onset. The patient’s condition was stable after interventional therapy, and his postoperative follow-up prognosis was favorable. Conclusions Endovascular stenting may be a feasible treatment for symptomatic severe stenosis of the DMCA in cases of poor control with standard medications.https://doi.org/10.1186/s12883-023-03456-4Duplicated middle cerebral arteryEndovascular stentingStenosisAcute ischemic strokeProgressive stroke
spellingShingle Lei Wang
Zhiyong Zhang
Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery
BMC Neurology
Duplicated middle cerebral artery
Endovascular stenting
Stenosis
Acute ischemic stroke
Progressive stroke
title Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery
title_full Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery
title_fullStr Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery
title_full_unstemmed Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery
title_short Endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery
title_sort endovascular stenting to treat an acute stroke caused by severe stenosis of the duplicated middle cerebral artery
topic Duplicated middle cerebral artery
Endovascular stenting
Stenosis
Acute ischemic stroke
Progressive stroke
url https://doi.org/10.1186/s12883-023-03456-4
work_keys_str_mv AT leiwang endovascularstentingtotreatanacutestrokecausedbyseverestenosisoftheduplicatedmiddlecerebralartery
AT zhiyongzhang endovascularstentingtotreatanacutestrokecausedbyseverestenosisoftheduplicatedmiddlecerebralartery