{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:39:35Z","timestamp":1792809575090,"version":"4.5.0"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>\n                    Until recently, cerebral arteriopathy due to heterozygous mutations of the\n                    <jats:italic>ACTA2<\/jats:italic>\n                    gene was considered a variant of moyamoya disease. However, radiographic analysis of patients with these mutations reveals a distinctive angiographic appearance from that seen in moyamoya disease. Several heterozygous missense\n                    <jats:italic>ACTA2<\/jats:italic>\n                    mutations have been implicated in the development of this distinct cerebrovascular entity; however, the penetrance and systemic manifestations of these mutations vary based on the location of the amino acid replacement within the \u03b1\u2013smooth muscle actin protein. The severity of the phenotype may also differ among patients within a single mutation type. There is limited literature on the safety and efficacy of revascularization procedures for\n                    <jats:italic>ACTA2<\/jats:italic>\n                    arteriopathy, which have been limited to those patients with known Arg179His mutations. The authors provide a review of the breadth of mutations within the\n                    <jats:italic>ACTA2<\/jats:italic>\n                    literature and report a case of two siblings with de novo\n                    <jats:italic>ACTA2<\/jats:italic>\n                    Arg258Cys mutations with differing clinical courses, highlighting the utility of indirect revascularization with 8-year follow-up data. This case highlights the importance of early recognition of the angiographic appearance of\n                    <jats:italic>ACTA2<\/jats:italic>\n                    cerebral arteriopathy and performance of genetic testing, as the location of the mutation impacts clinical presentation and outcomes.\n                  <\/jats:p>","DOI":"10.3171\/2020.8.peds20391","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T02:10:21Z","timestamp":1611886221000},"page":"446-451","source":"Crossref","is-referenced-by-count":7,"title":["Cerebral arteriopathy in ACTA2 mutations: a spectrum of disease highlighted by a case of variable penetrance in two siblings"],"prefix":"10.3171","volume":"27","author":[{"given":"Christine","family":"Tschoe","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teddy E.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle M.","family":"Fargen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey Q.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neuropathol Commun","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1186\/s40478-015-0262-7","article-title":"The defining pathology of the new clinical and histopathologic entity ACTA2-related cerebrovascular disease","volume":"3","author":"Georgescu M-M","year":"2015","unstructured":"Georgescu M-M, \nda Cunha Pinho M, \nRichardson TE, \n\n \nThe defining pathology of the new clinical and histopathologic entity ACTA2-related cerebrovascular disease. 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