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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
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Published on: September 25, 2009

The accessory middle cerebral artery: anatomic report.

Cassius V C Reis1, Joseph M Zabramski, Sam Safavi-Abbasi

  • 1Division of Neurological Surgery and Neurosurgical Research, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.

Neurosurgery
|September 9, 2008
PubMed
Summary

An accessory middle cerebral artery (MCA) originating from the A2 segment is a rare variation. This anatomical anomaly, identified in a cadaveric dissection, may increase the risk of aneurysms and complicate neurosurgery.

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Area of Science:

  • Neuroanatomy
  • Vascular Neurology
  • Surgical Anatomy

Background:

  • Accessory middle cerebral artery (MCA) typically arises between A1 and A2 segments.
  • This variation is linked to cerebral aneurysms and Moyamoya disease.

Purpose of the Study:

  • To report a case of an accessory MCA originating from the A2 segment.
  • To highlight the clinical significance and potential complications of this rare anomaly.

Main Methods:

  • Dissection of a formalin-fixed cadaveric head.
  • Vascular tree injection with silicone to visualize intracranial and extracranial vessels.

Main Results:

  • An accessory MCA was identified arising from the A2 segment of the anterior cerebral artery.
  • The anomalous vessel supplied the basal and inferior surface of the inferior frontal gyrus.
  • Intracranial aneurysms were present at other locations in the specimen.

Conclusions:

  • Accessory MCA is a rare but significant anatomical variation.
  • Associated risks include Moyamoya disease and aneurysms, particularly at the anterior cerebral artery junction.
  • This anomaly can increase surgical difficulty by obstructing visualization of nearby structures like the optic chiasm.