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. 2015 Oct 23;6(Suppl 21):S549-52.
doi: 10.4103/2152-7806.168069. eCollection 2015.

Aneurysm at origin of duplicated middle cerebral artery associated with another aneurysm

Yu Iida  1 , Akira Tamase  1 , Tomoya Kamide  1 , Kentaro Mori  1 , Shunsuke Seki  1 , Motohiro Nomura  1
Affiliations

Aneurysm at origin of duplicated middle cerebral artery associated with another aneurysm

Yu Iida et al. Surg Neurol Int. .

Abstract

Background: A duplicated middle cerebral artery (DMCA) is a rare vessel anomaly. Aneurysms at the origin of DMCA have been reported.

Case description: We report 2 cases of aneurysms at the origin of DMCA accompanied by aneurysms at different sites. Each case of ruptured and unruptured aneurysm at the DMCA origin was associated with an unruptured aneurysm at the ipsilateral internal carotid artery and a ruptured one at the ipsilateral MCA, respectively. The aneurysms were clipped successfully in both patients.

Conclusion: In cases of DMCA aneurysm associated with an aneurysm at another site, either aneurysm has a high risk of rupture. In such a case, radical treatment is necessary.

Keywords: Aneurysm; anomaly; duplicated; middle cerebral artery.

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Figures

Figure 1
Figure 1
Case 1. (a) Computed tomography on admission showing subarachnoid hemorrhage. (b) Angiography showing the right duplicated middle cerebral artery (arrowheads) and an aneurysm (arrow) at its origin. Angiography also showing a small internal carotid artery-posterior communicating artery aneurysm (open arrow). (c) An intra-operative photograph showing duplicated middle cerebral artery (arrowheads) and the aneurysm (arrow). (d) An intra-operative photograph also demonstrating the internal carotid artery-posterior communicating artery aneurysm (arrow). (e) The duplicated middle cerebral artery aneurysm is clipped. (f) Angiography obtained 8 years after onset, showing no recurrence of the aneurysms
Figure 2
Figure 2
Case 2. (a) Magnetic resonance imaging obtained 6 years previously showing two aneurysms on the right middle cerebral artery and the origin of duplicated middle cerebral artery. (b) Computed tomography on admission showing subarachnoid hemorrhage and intracerebral hemorrhage in the right temporal lobe. (c) Three-dimensional computed tomography angiography showing the right duplicated middle cerebral artery (arrowhead) and an aneurysm (arrow) at its origin. Three-dimensional computed tomography angiography also showing the right middle cerebral artery aneurysm (open arrow). (d) An intra-operative photograph showing duplicated middle cerebral artery (arrowheads), and the aneurysm (arrow) at its origin. (e) The unruptured duplicated middle cerebral artery aneurysm is successfully clipped. (f) An intra-operative photograph showing the ruptured middle cerebral artery aneurysm. (g) Postoperative angiography showing the disappearance of the aneurysms
See this image and copyright information in PMC

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