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[A Ruptured Aneurysm at the Origin of a Duplicated Middle Cerebral Artery, Treated by Coil Embolization:A Case

Kentaro Hayashi1, Yoshitaka Matsuo, Yukishige Hayashi

  • 1Department of Neurosurgery, Sasebo City General Hospital.

No Shinkei Geka. Neurological Surgery
|May 12, 2017
PubMed

Insights

A rare anatomical variant, duplicated middle cerebral artery (MCA), can lead to aneurysms and subarachnoid hemorrhage. Coil embolization effectively treated a ruptured aneurysm in this case, preserving MCA origin.

Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Neurology

Background:

  • Duplication of the middle cerebral artery (MCA) is a rare anatomical variation originating from the internal carotid artery (ICA).
  • Cerebral aneurysms can uncommonly develop at the bifurcation of the ICA and duplicated MCA, potentially causing subarachnoid hemorrhage.

Observation:

  • A 41-year-old male presented with severe headache due to subarachnoid hemorrhage.
  • Computed tomography (CT) revealed a ruptured aneurysm at the origin of a duplicated MCA.

Findings:

  • A small, laterally projecting aneurysm was successfully treated with balloon-assisted coil embolization.
  • The aneurysm neck was intentionally left un-embolized to preserve the duplicated MCA origin.
  • The patient experienced an uneventful recovery and resumed normal activities.

Implications:

  • Coil embolization is a promising, potentially first-line treatment for aneurysms associated with duplicated MCAs.
  • Careful balloon-assisted techniques are recommended due to the risk of intraprocedural rupture in small aneurysms.
  • This case highlights successful endovascular management of a rare cerebrovascular anomaly.

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