{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T07:02:25Z","timestamp":1764313345695,"version":"3.46.0"},"reference-count":13,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Cerebral arteriovenous malformation (AVM) is a congenital condition characterized by abnormal direct connections between arteries and veins through a nidus. Occlusion of major feeding arteries in AVMs is rare and typically associated with moyamoya disease. To date, only three cases have been reported where a previously patent major feeding artery became occluded during follow-up in AVMs without moyamoya disease.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 36-year-old man presented with a seizure and was diagnosed with a left temporal lobe AVM. He was treated conservatively with antiepileptic medication. At age 49, follow-up angiography revealed middle cerebral artery (MCA) stenosis at the M1 segment. Eleven years later, at age 60, the MCA was occluded at the M1 segment, with collateral flow through M1-M1 micro-anastomoses and increased leptomeningeal and transdural anastomoses. Despite this angiographic progression, the patient remained asymptomatic except for well-controlled seizures, and conservative management was continued.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This case illustrates a rare instance of spontaneous progressive occlusion of the MCA \u2013 the main feeder of an AVM \u2013 unrelated to moyamoya disease, with collateral revascularization captured over a 24-year follow-up. It underscores the importance of ongoing imaging surveillance, even in clinically stable patients, to anticipate treatment complexity resulting from dynamic hemodynamic changes.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_545_2025","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T07:00:17Z","timestamp":1764313217000},"page":"506","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Progressive occlusion of the middle cerebral artery as the main feeder in a cerebral arteriovenous malformation: A case report"],"prefix":"10.25259","volume":"16","author":[{"given":"Takaaki","family":"Kitano","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hikone Municipal Hospital, Hikone, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hikone Municipal Hospital, Hikone, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isao","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hikone Municipal Hospital, Hikone, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Chihara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"10.25259\/SNI_545_2025\/ref-1","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1227\/00006123-198505000-00013","article-title":"Arteriovenous malformation in the territory of the occluded middle cerebral artery with massive intraoperative brain swelling: Case report","volume":"16","author":"Aoki","year":"1985","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_545_2025\/ref-2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.3171\/2016.5.JNS16730","article-title":"Transdural arterial recruitment to brain arteriovenous malformation: Clinical and management implications in a prospective cohort series","volume":"127","author":"Bervini","year":"2017","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_545_2025\/ref-3","doi-asserted-by":"crossref","first-page":"661611","DOI":"10.3389\/fneur.2023.661611","article-title":"Physiological and pathophysiological mechanisms of the molecular and cellular biology of angiogenesis and inflammation in moyamoya angiopathy and related vascular diseases","volume":"14","author":"Dorschel","year":"2023","journal-title":"Front Neurol"},{"key":"10.25259\/SNI_545_2025\/ref-4","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1097\/00006123-199911000-00018","article-title":"Association of cerebral arteriovenous malformations and spontaneous occlusion of major feeding arteries: Clinical and therapeutic implications","volume":"45","author":"Enam","year":"1999","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_545_2025\/ref-5","doi-asserted-by":"crossref","first-page":"869","DOI":"10.3171\/jns.2004.101.5.0869","article-title":"Hemorrhage from moyamoya-like vessels associated with a cerebral arteriovenous malformation. 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