{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T15:59:20Z","timestamp":1765382360464},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Middle cerebral artery (MCA) has a significantly lower incidence of anatomical variations than other intracranial arteries. We present an extremely rare case of unruptured aneurysms with the segmental duplicated MCA (d-MCA) formed a fenestrated structure at origin.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 55-year-old female underwent direct surgery for the unruptured aneurysms at the top of the right internal cerebral artery with d-MCA. The d-MCA branches separated at the right internal cerebral artery top and had comparable with that of the main MCA trunk. Moreover, there was an anastomosis between the d-MCA branches. We diagnosed this anastomosis as segmental d-MCA. Two aneurysmal domes were identified during surgery at the origin of the d-MCA, which the main dome protruding backward was wide necked and another small one was collapsed or thrombosed protruding forward. We used a fenestrated clip for the posterior projecting dome, and the aneurysms were successfully obliterated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Although cerebral aneurysms associated with d-MCA are rare, there are technical difficulties in the surgical management. A fenestrated clip might be most reasonable to obtain patency of the parent arteries for the posterior projecting aneurysms if the perforators can be avoided.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1108_2021","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T05:51:09Z","timestamp":1643349069000},"page":"33","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Unruptured cerebral aneurysms with the segmental duplicated middle cerebral artery formed a fenestrated structure at origin"],"prefix":"10.25259","volume":"13","author":[{"given":"Eri","family":"Shiozaki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daiki","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoichi","family":"Morofuji","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonori","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wataru","family":"Haraguchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National 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