Successful endovascular recanalization of acute accessory middle cerebral artery occlusion; A case report and literature review

Abstract

The accessory middle cerebral artery (AMCA) is a rare anomaly of the middle cerebral artery (MCA). Ischemic stroke associated with AMCA had hardly been reported; therefore, the pathological condition, symptom, and treatment are not well-documented. Herein, we present a case of the ischemic stroke due to AMCA occlusion treated by mechanical thrombectomy.A 76-year-old woman with acute onset of aphasia was transferred to our hospital. The left AMCA and its occlusion were detected by computed tomography angiography. Magnetic resonance images showed the acute infarction of prefrontal areas, anterior insula, and anterior temporal area. Atrial fibrillation was observed by electrocardiogram, suggesting acute cerebral infarction due to embolic etiology. We successfully performed mechanical thrombectomy for occluded AMCA using a small profile of stent retriever.This is the first case report illustrating the successful endovascular treatment for acute ischemic stroke due to occluded AMCA. We demonstrated the efficacy of mechanical thrombectomy for this rare clinical condition.

Keywords

• Ischemic stroke
• Accessory middle cerebral artery
• Endovascular treatment