{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:27Z","timestamp":1756377627082,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,10,17]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>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\u2009hours 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.<\/jats:p>","DOI":"10.1136\/bcr-2022-251221","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T11:45:28Z","timestamp":1699011928000},"page":"e251221","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Rare case of duplicated middle cerebral artery and acute ischaemic stroke managed successfully with mechanical thrombectomy"],"prefix":"10.1136","volume":"16","author":[{"given":"Subash","family":"Phuyal","sequence":"first","affiliation":[{"name":"Neuroimaging and Interventional Radiology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5206-0740","authenticated-orcid":false,"given":"Lekhjung","family":"Thapa","sequence":"additional","affiliation":[{"name":"Neurology, National Neuro Centre, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biswa Mohan","family":"Mishra","sequence":"additional","affiliation":[{"name":"Departemnt of Neurology, All india institute of Medical sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1146-2302","authenticated-orcid":false,"given":"Manoj Kumar","family":"Nayak","sequence":"additional","affiliation":[{"name":"Radiodiagnosis, AIIMS Bhubaneswar, Bhubaneswar, Orissa, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"2025082803171165000_16.11.e251221.1","first-page":"671","article-title":"Anatomy of the middle cerebral artery: cortical branches, branching pattern and anomalies","volume":"27","author":"Cilliers","year":"2017","journal-title":"Turk Neurosurg"},{"key":"2025082803171165000_16.11.e251221.2","first-page":"45","article-title":"Middle cerebral artery variations: duplicated and accessory arteries","volume":"19","author":"Komiyama","year":"1998","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082803171165000_16.11.e251221.3","first-page":"391","article-title":"A ruptured aneurysm at the origin of a duplicated middle cerebral artery, treated by coil embolization:a case report","volume":"45","author":"Hayashi","year":"2017","journal-title":"No Shinkei Geka"},{"key":"2025082803171165000_16.11.e251221.4","doi-asserted-by":"crossref","first-page":"223","DOI":"10.7461\/jcen.2015.17.3.223","article-title":"An unruptured cerebral aneurysm at the origin of the duplicated middle cerebral artery","volume":"17","author":"Kim","year":"2015","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"key":"2025082803171165000_16.11.e251221.5","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.jstrokecerebrovasdis.2009.08.007","article-title":"Unruptured middle cerebral artery aneurysm associated with a duplicated middle cerebral artery and a dolichoectasic anterior cerebral artery","volume":"19","author":"Miyamoto","year":"2010","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2025082803171165000_16.11.e251221.6","doi-asserted-by":"crossref","first-page":"102","DOI":"10.3340\/jkns.2011.49.2.102","article-title":"Middle cerebral artery duplication: classification and clinical implications","volume":"49","author":"Chang","year":"2011","journal-title":"J Korean Neurosurg Soc"},{"key":"2025082803171165000_16.11.e251221.7","doi-asserted-by":"crossref","first-page":"732","DOI":"10.33588\/rn.3808.2003207","article-title":"[Anatomical variations of the middle cerebral artery: duplication and accessory artery implications in the treatment of acute stroke]","volume":"38","author":"Vila Moriente","year":"2004","journal-title":"Rev Neurol"},{"key":"2025082803171165000_16.11.e251221.8","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.15.11041"},{"key":"2025082803171165000_16.11.e251221.9","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S0140-6736(62)90281-7","article-title":"The pathology of ruptured middle-cerebral aneurysms with special reference to the differences between the sexes","volume":"2","author":"CROMPTON","year":"1962","journal-title":"Lancet"},{"key":"2025082803171165000_16.11.e251221.10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.wneu.2018.11.223","article-title":"Vessel wall injury after stent retriever thrombectomy for internal carotid artery occlusion with duplicated middle cerebral artery","volume":"123","author":"Koge","year":"2019","journal-title":"World Neurosurg"},{"key":"2025082803171165000_16.11.e251221.11","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.118.3.567"},{"key":"2025082803171165000_16.11.e251221.12","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1212\/WNL.0000000000001894","article-title":"Severe MCA stroke without MCA occlusion? Thrombectomy Uncovers accessory middle cerebral artery","volume":"85","author":"Bayer-Karpinska","year":"2015","journal-title":"Neurology"},{"key":"2025082803171165000_16.11.e251221.13","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000619"},{"key":"2025082803171165000_16.11.e251221.14","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"2025082803171165000_16.11.e251221.15","doi-asserted-by":"crossref","first-page":"187","DOI":"10.4103\/0972-2327.144289","article-title":"Study of middle cerebral artery in human cadaveric brain","volume":"22","author":"Gunnal","year":"2019","journal-title":"Ann Indian Acad Neurol"},{"key":"2025082803171165000_16.11.e251221.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.01.034"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:17:19Z","timestamp":1756376239000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,3]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/bcr-2022-251221"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251221","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}