{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:49:50Z","timestamp":1785527390842,"version":"3.56.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T00:00:00Z","timestamp":1705276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,15]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Twig-like middle cerebral artery (T-MCA) is reported as a rare vascular anomaly characterized by reconstitution of the M1 segment of the middle cerebral artery (MCA) by a plexiform network of small vessels. Although it is generally believed that the etiology of T-MCA is an embryological persistence, some investigators have suggested that T-MCA may be a secondary consequence. Here, the authors report a second case of de novo T-MCA formation and reconsider the concept of T-MCA in connection with isolated MCA disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 40-year-old man\u2019s brain magnetic resonance imaging (MRI) checkup showed moderate stenosis of the M1 segment of the left MCA. Annual MRI follow-up was planned, and when performed 1 year later, it showed occlusion of the M1 segment of the left MCA. Cerebral angiography revealed occlusion of that M1 segment with abnormal arterial networks. This case was diagnosed as de novo T-MCA. The patient has remained asymptomatic for 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The reports of de novo T-MCA indicate that acquired factors may be involved in the pathogenesis of T-MCA. We suggest that T-MCA should be defined as a variety of isolated MCA disease with new vessel formation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23621","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T18:54:15Z","timestamp":1705344855000},"source":"Crossref","is-referenced-by-count":9,"title":["Twig-like middle cerebral artery as a variety of isolated middle cerebral artery disease with new vessel formation: illustrative case"],"prefix":"10.3171","volume":"7","author":[{"given":"Hideki","family":"Nakajima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuma","family":"Iwaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Hongo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morio","family":"Takasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Fujimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Jpn J Stroke","first-page":"190","article-title":"Aplastic or twig-like cerebral artery with short-term ischemia and bleeding","volume":"42","author":"Yamada D","year":"2020","unstructured":"Yamada D, Ishibashi R, Kinosada M, Kurosaki Y, Handa A, Chin M Aplastic or twig-like cerebral artery with short-term ischemia and bleeding. Jpn J Stroke. 2020;42(3):190\u2013195."},{"issue":"4","key":"b2","series-title":"AJNR Am J Neuroradiol","first-page":"585","article-title":"Angiographic and embryologic considerations in five cases of middle cerebral artery fenestration","volume":"23","author":"Gailloud P","year":"2002","unstructured":"Gailloud P, Albayram S, Fasel JH, Beauchamp NJ, Murphy KJ Angiographic and embryologic considerations in five cases of middle cerebral artery fenestration. AJNR Am J Neuroradiol. 2002;23(4):585\u2013587."},{"issue":"1","key":"b3","series-title":"Cerebrovasc Dis","first-page":"1","article-title":"Aneurysms in twig-like middle cerebral artery","volume":"20","author":"Liu HM","year":"2005","unstructured":"Liu HM, Lai DM, Tu YK, Wang YH Aneurysms in twig-like middle cerebral artery. Cerebrovasc Dis. 2005;20(1):1\u20135."},{"issue":"1","key":"b4","series-title":"Clin Imaging","first-page":"31","article-title":"Twig-like middle cerebral arteries: clinical and radiological findings","volume":"73","author":"Onoue K","year":"2021","unstructured":"Onoue K, Nguyen TN, Mian A, Dasenbrock H, Bedi H, Abdalkader M Twig-like middle cerebral arteries: clinical and radiological findings. Clin Imaging. 2021;73(1):31\u201337."},{"issue":"9","key":"b5","series-title":"J Neurosurg Case Lessons","first-page":"CASE21360","article-title":"Aplastic or twig-like middle cerebral artery harboring unruptured cerebral aneurysms treated by clipping and bypass surgery: illustrative case","volume":"2","author":"Takarada A","year":"2021","unstructured":"Takarada A, Yanaka K, Onuma K, Nakamura K, Takahashi N, Ishikawa E Aplastic or twig-like middle cerebral artery harboring unruptured cerebral aneurysms treated by clipping and bypass surgery: illustrative case. 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Brain Behav. 2018;8(10):e01088."},{"issue":"6","key":"b9","series-title":"Neurosurgery","first-page":"1472","article-title":"Clinical and radiological features of patients with aplastic or twiglike middle cerebral arteries","volume":"70","author":"Seo BS","year":"2012","unstructured":"Seo BS, Lee YS, Lee HG, Lee JH, Ryu KY, Kang DG Clinical and radiological features of patients with aplastic or twiglike middle cerebral arteries. Neurosurgery. 2012;70(6):1472\u20131480."},{"issue":"6","key":"b10","series-title":"Neurol Med Chir (Tokyo)","first-page":"261","article-title":"Anomalies of the middle cerebral artery","volume":"57","author":"Uchiyama N","year":"2017","unstructured":"Uchiyama N Anomalies of the middle cerebral artery. Neurol Med Chir (Tokyo). 2017;57(6):261\u2013266."},{"issue":"2","key":"b11","series-title":"J Neurosurg","first-page":"653","article-title":"Letter to the editor. Rete middle cerebral artery anomalies","volume":"131","author":"Brinjikji W","year":"2019","unstructured":"Brinjikji W, Lanzino G Letter to the editor. Rete middle cerebral artery anomalies. J Neurosurg. 2019;131(2):653\u2013654."},{"issue":"6","key":"b12","series-title":"J Neurosurg","first-page":"1875","article-title":"Letter to the editor. Twig-like middle cerebral artery and moyamoya disease","volume":"137","author":"Ota T","year":"2022","unstructured":"Ota T Letter to the editor. Twig-like middle cerebral artery and moyamoya disease. J Neurosurg. 2022;137(6):1875\u20131876."},{"issue":"4","key":"b13","series-title":"Interv Neuroradiol","first-page":"584","article-title":"Twig-like middle cerebral artery: Embryological persistence or secondary consequences?","volume":"27","author":"Ota T","year":"2021","unstructured":"Ota T, Komiyama M Twig-like middle cerebral artery: Embryological persistence or secondary consequences? 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