논문 (학술지)
Twig-Like Middle Cerebral Artery : Acquired Lesion Rather than Congenital Anomaly
| 등록번호 | - | SCI 구분
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※구분 : SCI(SCIE포함), 비SCI |
SCI |
|---|---|---|---|
| 저자명 (주·공동저자) | 박영기; 정진환; 윤별희; 황의현; 강희인; 김재훈 | ||
| 논문구분 | 국외전문학술지 | 학술지명 | Journal of Korean Neurosurgical Society |
| ISSN | 2005-3711 | 학술지 출판일자 | 2025-12-31 |
| 학술지 볼륨번호 | 69(1) | 논문페이지 | 51 ~ 60 |
| 학술지 임팩트팩터 | 1.7 | 기여율 | 30 % |
| DOI | https://doi.org/10.3340/jkns.2025.0059 | ||
| 초록 | Objective A twig-like middle cerebral artery (T-MCA) is a rare condition characterized by steno-occlusion of the M1 segment of the middle cerebral artery (MCA) with nearby collateral arterial networks. Despite unclear pathophysiology, it is often classified as a congenital anomaly caused by failure of fusion of the plexiform MCA arterial plexus. We aimed to improve understanding of the pathophysiology of T-MCAs by analyzing incidental T-MCA findings and their natural history. Methods A retrospective chart review was performed between January 2011 and December 2023 at three medical centers treating both ischemic and hemorrhagic strokes. Patients with suspected MCA lesions were selected through radiology reports from computed tomography, magnetic resonance angiography, and digital subtraction imaging. Results We identified 51 T-MCA cases from a radiology report search spanning 13 years across three medical centers. The study included 9875 patients with ischemic stroke and 2097 with hemorrhagic stroke. Of the 51 T-MCA cases, incidental findings accounted for 25 (49.0%), ischemic stroke for 18 (35.3%), and hemorrhagic strokes accounted for eight cases (15.7%). T-MCA related ischemic and hemorrhagic strokes accounted for 0.18-0.38% of all strokes. The RNF213.R4810K mutation was identified in seven of 15 patients (46.7%) tested. We found three cases of a de-novo T-MCA that progressed from a normal MCA architecture. Conclusion T-MCAs may represent an acquired secondary anomaly rather than a congenital lesion, followed by steno-occlusion of the focal MCA with new arterial network formation. Both Moyamoya angiopathy and chronic atherosclerosis likely contributed to disease progression. Formation of a microaneurysm, dilatation of the lenticulostriate artery, and hemodynamic stress can lead to stroke. | ||
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