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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
18:50

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

Published on: September 25, 2009

Duplicated middle cerebral artery

Jesus Perez1, Calixto Machado, Claudio Scherle

  • 1Hermanos Ameijeiras Hospital, Neurology, San Lazaro 701, Havana, Havana, 10300, Cuba.

BMJ Case Reports
|December 6, 2011
PubMed

Insights

Duplicated middle cerebral artery (DMCA) can have perforating arteries, crucial information for cerebral aneurysm surgery. This finding confirms DMCA

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neurosurgery

Background:

  • Duplicated middle cerebral artery (DMCA) is a rare vascular anomaly originating from the internal carotid artery.
  • A link between DMCA and cerebral aneurysms is recognized, but the presence of perforating arteries remains debated.
  • Understanding DMCA anatomy is vital for neurosurgical interventions, particularly aneurysm clipping.

Purpose of the Study:

  • To report a case of subarachnoid hemorrhage caused by a cerebral aneurysm in a patient with DMCA.
  • To investigate the presence of perforating arteries arising from both the DMCA and the main middle cerebral artery (MCA).
  • To highlight the surgical implications of DMCA perforating arteries in managing cerebral aneurysms.

Main Methods:

  • Case report of a 34-year-old woman with subarachnoid hemorrhage.
  • Cerebral angiography to visualize vascular anatomy, including DMCA and aneurysm.
  • Surgical clipping of the cerebral aneurysm.

Main Results:

  • Angiography revealed a left DMCA and an aneurysm on an inferior branch of the main MCA.
  • Both the DMCA and the main MCA were found to possess perforating arteries.
  • The cerebral aneurysm was successfully clipped without complications.

Conclusions:

  • This case confirms that DMCA can indeed have perforating arteries.
  • The presence of perforating arteries in DMCA is a critical consideration for neurosurgeons operating on cerebral aneurysms.
  • DMCA may offer collateral blood supply to the MCA territory, potentially aiding in cases of MCA occlusion.

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