Clinical and Radiological Features of Patients With Aplastic or Twiglike Middle Cerebral Arteries
Clinical and Radiological Features of Patients With Aplastic or Twiglike Middle Cerebral Arteries
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DOI：
10.1227/neu.0b013e318246a510
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发表时间：
2012-06-01
期刊：
影响因子：
4.8
通讯作者：
Kang, Dong-Gee
中科院分区：
文献类型：
--
作者：
Seo, Byung-Sun;Lee, Yoon-Soo;Kang, Dong-Gee
背景：发育不良或树枝状大脑中动脉（Ap/T-MCA）是一种极其罕见的先天性异常，与干扰大脑中动脉正常胚胎发育有关。 目的：评估 Ap/T-MCA 患者的临床和放射学特征。 方法：2005 年 1 月至 2011 年 7 月在大邱法蒂玛对 1282 名患者进行了 1749 例常规脑血管造影手术。医院。对图像进行脑动脉异常评估。记录 Ap/T-MCA 的放射学特征、共存异常和临床表现。对这些前瞻性维护的数据库进行了回顾性分析。结果：在 15 名患者中发现 Ap/T-MCA（血管造影发生率为 1.17%）。异常仅限于单侧M1段，邻近大动脉未见狭窄。 15 名患者中，6 名（40%）患有出血性中风，5 名（33.3%）患有缺血性中风，4 名（26.7%）没有症状。 5 名患者（33.3%）发现动脉瘤。 12 名患者（80%）同时存在脑动脉异常。 10例患者接受保守治疗，其余5例接受手术治疗，如血肿抽吸、间接血运重建、动脉瘤夹闭或弹簧圈栓塞等。 结论：Ap/T-MCA是一种罕见的异常情况，应与烟雾病和大脑中动脉退行性狭窄闭塞性疾病相鉴别。大脑前动脉或中动脉的共存异常很常见。这种异常很容易发生出血性和缺血性中风。
BACKGROUND: An aplastic or twiglike middle cerebral artery (Ap/T-MCA) is an extremely rare congenital anomaly related to interference in the normal embryonic development of the MCA.OBJECTIVE: To evaluate the clinical and radiological features of patients with an Ap/T-MCA.METHODS: A total of 1749 conventional cerebral angiography procedures were performed in 1282 patients from January 2005 to July 2011 at Daegu Fatima Hospital. The images were evaluated for cerebral arterial anomalies. The radiological features of an Ap/T-MCA, coexisting anomalies, and clinical manifestations were recorded. These prospectively maintained databases were analyzed retrospectively.RESULTS: Ap/T-MCAs were found in 15 patients (1.17% angiographic incidence). The anomalies were confined to unilateral M1 segment, and no stenoses were seen in the adjacent major arteries. Of 15 patients, 6 (40%) had hemorrhagic strokes, 5 (33.3%) had ischemic strokes, and 4 (26.7%) had no symptoms. Aneurysms were found in 5 patients (33.3%). Coexisting cerebral arterial anomalies were seen in 12 patients (80%). Ten patients underwent conservative treatments, and the remaining 5 underwent surgical treatments, such as hematoma aspiration, indirect revascularization, and clipping or coiling of aneurysms.CONCLUSION: An Ap/T-MCA is a rare anomaly and should be differentiated from moyamoya conditions and degenerative steno-occlusive diseases of the middle cerebral artery. Coexisting anomalies of the anterior or middle cerebral arteries are frequent. This anomaly is vulnerable to both hemorrhagic and ischemic strokes.