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Case Reports: Rare disease
Rare case of duplicated middle cerebral artery and acute ischaemic stroke managed successfully with mechanical thrombectomy
  1. Subash Phuyal1,
  2. Lekhjung Thapa2,
  3. Biswa Mohan Mishra3 and
  4. Manoj Kumar Nayak4
  1. 1Neuroimaging and Interventional Radiology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal
  2. 2Neurology, National Neuro Centre, Kathmandu, Nepal
  3. 3Departemnt of Neurology, All india institute of Medical sciences, New Delhi, Delhi, India
  4. 4Radiodiagnosis, AIIMS Bhubaneswar, Bhubaneswar, Orissa, India
  1. Correspondence to Dr Manoj Kumar Nayak; tuna.manoj{at}gmail.com

Abstract

A man in his early 80s presented with acute onset aphasia and right-sided weakness with an NIH Stroke Scale (NIHSS) of 17. He was last seen normal 9 hours before the presentation. MRI of the brain showed acute infarcts in the left caudate, lentiform nucleus and corona radiata. MRI angiogram (MRA) revealed an occluded left main middle cerebral artery (MCA) and an associated ipsilateral patent duplicated middle cerebral artery (DMCA). Mechanical thrombectomy (MT) was performed, and he was discharged with an NIHSS of 8. In this report, we review and discuss the challenges during the intervention of MCA occlusion in the presence of duplicated MCA, a rare anomaly.

  • neuroimaging
  • stroke

https://doi.org/10.1136/bcr-2022-251221

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: drafting of the text and sourcing and editing of clinical images, BMM and MKN; investigation results, SP; and critical revision for important intellectual content, LT. The following authors gave final approval of the manuscript: LT and SP.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.