{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:07:03Z","timestamp":1770372423986,"version":"3.49.0"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"22","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,6,2]]},"abstract":"\n BACKGROUND<\/jats:title>\n This study reports a case investigating the long-term progression of moyamoya disease (MMD) involving a duplicated middle cerebral artery (MCA). MMD is characterized by progressive stenosis of the terminal internal carotid artery (ICA) and its terminal branches, which is accompanied by the formation of collateral vessels.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 49-year-old Japanese woman diagnosed with MMD at 38 years of age was found to have a duplicated right MCA through digital subtraction angiography. Two years after the diagnosis, the vascular lesion progressed, leading to dropout of the right proximal anterior cerebral artery and disappearance of the bilateral anterior cerebral artery. She experienced a transient ischemic attack 2 years after the diagnosis and underwent bilateral revascularization. Eleven years of follow-up revealed no stenosis in either the MCA or ICA.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n The progression of MMD may be attributed to shear stress that might have weakened the ICA distal to the duplicated MCA. Blood flow to the duplicated MCA was maintained, and the proximal ICA did not develop stenosis due to the preservation of shear stress.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE2598<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case2598","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T19:46:06Z","timestamp":1749498366000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-term follow-up of moyamoya disease in a patient with a duplicated middle cerebral artery: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Kaori","family":"Honjo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Osato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0107-6598","authenticated-orcid":true,"given":"Yuuki","family":"Amano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suguru","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiru","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hakodate Neurosurgical Hospital, Hakodate, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiichi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirohiko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Rinsho Hoshasen","first-page":"449","article-title":"Accessory or duplicated middle cerebral artery","volume":"20","author":"Ito","year":"1975","unstructured":"Ito JSato TArai HHonda H.Accessory or duplicated middle cerebral artery. Rinsho Hoshasen. 1975;20(6):449-457."},{"issue":"509","key":"bib2","series-title":"Br J Radiol","first-page":"314","article-title":"Two cases of accessory middle cerebral artery, including one with an aneurysm at its origin","volume":"43","author":"Stabler","year":"1970","unstructured":"Stabler J.Two cases of accessory middle cerebral artery, including one with an aneurysm at its origin. Br J Radiol. 1970;43(509):314-318."},{"issue":"3","key":"bib3","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"567","article-title":"Anomalies of the middle cerebral artery: accessory artery, duplication, and early bifurcation","volume":"118","author":"Teal","year":"1973","unstructured":"Teal JSRumbaugh CLBergeron RTSegall HD.Anomalies of the middle cerebral artery: accessory artery, duplication, and early bifurcation. Am J Roentgenol Radium Ther Nucl Med. 1973;118(3):567-575."},{"issue":"suppl 2","key":"bib4","series-title":"Clin Neurol Neurosurg","first-page":"S1","article-title":"Epidemiological features of Moyamoya disease in Japan: findings from a nationwide survey","volume":"99","author":"Wakai","year":"1997","unstructured":"Wakai KTamakoshi AIkezaki KEpidemiological features of Moyamoya disease in Japan: findings from a nationwide survey. Clin Neurol Neurosurg. 1997;99(suppl 2):S1-S5."},{"issue":"3","key":"bib5","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki","year":"1969","unstructured":"Suzuki JTakaku A.Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol. 1969;20(3):288-299."},{"key":"bib6","series-title":"Front Neurol","first-page":"661578","article-title":"Pathophysiology of vascular stenosis and remodeling in Moyamoya disease","volume":"12","author":"Fox","year":"2021","unstructured":"Fox BMDorschel KBLawton MTWanebo JE.Pathophysiology of vascular stenosis and remodeling in Moyamoya disease. Front Neurol. 2021;12:661578."},{"issue":"1","key":"bib7","series-title":"J Hum Genet","first-page":"34","article-title":"A genome-wide association study identifies RNF213 as the first Moyamoya disease gene","volume":"56","author":"Kamada","year":"2011","unstructured":"Kamada FAoki YNarisawa AA genome-wide association study identifies RNF213 as the first Moyamoya disease gene. J Hum Genet. 2011;56(1):34-40."},{"issue":"1","key":"bib8","series-title":"Surg Neurol","first-page":"39","article-title":"Association of middle cerebral artery anomalies with saccular aneurysms and Moyamoya disease","volume":"6","author":"Ya\u015fargil","year":"1976","unstructured":"Ya\u015fargil MGSmith RD.Association of middle cerebral artery anomalies with saccular aneurysms and Moyamoya disease. Surg Neurol. 1976;6(1):39-43."},{"issue":"1","key":"bib9","series-title":"J Neurol Neurosurg Psychiatry","first-page":"129","article-title":"Accessory middle cerebral artery and Moyamoya disease","volume":"71","author":"Komiyama","year":"2001","unstructured":"Komiyama MYasui T.Accessory middle cerebral artery and Moyamoya disease. J Neurol Neurosurg Psychiatry. 2001;71(1):129-130."},{"issue":"5","key":"bib10","series-title":"Chang Gung Med J","first-page":"541","article-title":"Ruptured aneurysm of the accessory middle cerebral artery associated with Moyamoya disease: a case report","volume":"34","author":"Lee","year":"2011","unstructured":"Lee CCLiu ZHJung SMYang TC.Ruptured aneurysm of the accessory middle cerebral artery associated with Moyamoya disease: a case report. Chang Gung Med J. 2011;34(5):541-547."},{"issue":"6","key":"bib11","series-title":"Jpn J Stroke","first-page":"457","article-title":"A case of Moyamoya disease associated with the accessory middle cerebral artery and an aneurysm at its origin","volume":"35","author":"Kanata","year":"2013","unstructured":"Kanata AKatsuta TTsukamoto H.A case of Moyamoya disease associated with the accessory middle cerebral artery and an aneurysm at its origin. 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J Stroke. 2016;18(1):12-20."},{"issue":"2","key":"bib17","series-title":"Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub","first-page":"159","article-title":"Moyamoya disease is associated with endothelial activity detected by anti-nestin antibody","volume":"154","author":"Chmelova","year":"2010","unstructured":"Chmelova JKolar ZProchazka VMoyamoya disease is associated with endothelial activity detected by anti-nestin antibody. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010;154(2):159-162."},{"issue":"2","key":"bib18","series-title":"Neurosurgery","first-page":"338","article-title":"Expression of hypoxia-inducing factor-1 alpha and endoglin in intimal hyperplasia of the middle cerebral artery of patients with Moyamoya disease","volume":"60","author":"Takagi","year":"2007","unstructured":"Takagi YKikuta KINozaki KExpression of hypoxia-inducing factor-1 alpha and endoglin in intimal hyperplasia of the middle cerebral artery of patients with Moyamoya disease. 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Brain Res. 2014;1552:64-71."},{"issue":"2","key":"bib21","series-title":"J Stroke","first-page":"65","article-title":"Genetics and biomarkers of Moyamoya disease: significance of RNF213 as a susceptibility gene","volume":"16","author":"Fujimura","year":"2014","unstructured":"Fujimura MSonobe SNishijima YGenetics and biomarkers of Moyamoya disease: significance of RNF213 as a susceptibility gene. J Stroke. 2014;16(2):65-72."},{"issue":"6 Pt 2","key":"bib22","series-title":"Am J Physiol","first-page":"H1145","article-title":"Flow-induced release of endothelium-derived relaxing factor","volume":"250","author":"Rubanyi","year":"1986","unstructured":"Rubanyi GMRomero JCVanhoutte PM.Flow-induced release of endothelium-derived relaxing factor. Am J Physiol. 1986;250(6 Pt 2):H1145-H1149."},{"issue":"7","key":"bib23","series-title":"Blood","first-page":"2667","article-title":"Shear stress inhibits adhesion molecule expression in vascular endothelial cells induced by coculture with smooth muscle cells","volume":"101","author":"Chiu","year":"2003","unstructured":"Chiu JJChen LJLee PLShear stress inhibits adhesion molecule expression in vascular endothelial cells induced by coculture with smooth muscle cells. Blood. 2003;101(7):2667-2674."},{"key":"bib24","series-title":"Annu Rev Biomed Eng","first-page":"299","article-title":"Fluid mechanics of vascular systems, diseases, and thrombosis","volume":"1","author":"Wootton","year":"1999","unstructured":"Wootton DMKu DN.Fluid mechanics of vascular systems, diseases, and thrombosis. Annu Rev Biomed Eng. 1999;1:299-329."},{"issue":"3","key":"bib25","series-title":"J Neurosurg Pediatr","first-page":"297","article-title":"Computational analysis of hemodynamics using a two-dimensional model in Moyamoya disease","volume":"5","author":"Seol","year":"2010","unstructured":"Seol HJShin DCKim YSComputational analysis of hemodynamics using a two-dimensional model in Moyamoya disease. J Neurosurg Pediatr. 2010;5(3):297-301."},{"issue":"5","key":"bib26","series-title":"Acta Neurochir (Wien)","first-page":"755","article-title":"Morphology and related hemodynamics of the internal carotid arteries of moyamoya patients","volume":"157","author":"Kim","year":"2015","unstructured":"Kim TBang JSKwon OKMorphology and related hemodynamics of the internal carotid arteries of moyamoya patients. Acta Neurochir (Wien). 2015;157(5):755-761."},{"issue":"6","key":"bib1","series-title":"Rinsho Hoshasen","first-page":"449","article-title":"Accessory or duplicated middle cerebral artery","volume":"20","author":"Ito","year":"1975","unstructured":"Ito JSato TArai HHonda H.Accessory or duplicated middle cerebral artery. Rinsho Hoshasen. 1975;20(6):449-457."},{"issue":"509","key":"bib2","series-title":"Br J Radiol","first-page":"314","article-title":"Two cases of accessory middle cerebral artery, including one with an aneurysm at its origin","volume":"43","author":"Stabler","year":"1970","unstructured":"Stabler J.Two cases of accessory middle cerebral artery, including one with an aneurysm at its origin. Br J Radiol. 1970;43(509):314-318."},{"issue":"3","key":"bib3","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"567","article-title":"Anomalies of the middle cerebral artery: accessory artery, duplication, and early bifurcation","volume":"118","author":"Teal","year":"1973","unstructured":"Teal JSRumbaugh CLBergeron RTSegall HD.Anomalies of the middle cerebral artery: accessory artery, duplication, and early bifurcation. Am J Roentgenol Radium Ther Nucl Med. 1973;118(3):567-575."},{"issue":"suppl 2","key":"bib4","series-title":"Clin Neurol Neurosurg","first-page":"S1","article-title":"Epidemiological features of Moyamoya disease in Japan: findings from a nationwide survey","volume":"99","author":"Wakai","year":"1997","unstructured":"Wakai KTamakoshi AIkezaki KEpidemiological features of Moyamoya disease in Japan: findings from a nationwide survey. Clin Neurol Neurosurg. 1997;99(suppl 2):S1-S5."},{"issue":"3","key":"bib5","series-title":"Arch Neurol","first-page":"288","article-title":"Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain","volume":"20","author":"Suzuki","year":"1969","unstructured":"Suzuki JTakaku A.Cerebrovascular \u201cmoyamoya\u201d disease. Disease showing abnormal net-like vessels in base of brain. Arch Neurol. 1969;20(3):288-299."},{"key":"bib6","series-title":"Front Neurol","first-page":"661578","article-title":"Pathophysiology of vascular stenosis and remodeling in Moyamoya disease","volume":"12","author":"Fox","year":"2021","unstructured":"Fox BMDorschel KBLawton MTWanebo JE.Pathophysiology of vascular stenosis and remodeling in Moyamoya disease. 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Surg Neurol. 1976;6(1):39-43."},{"issue":"1","key":"bib9","series-title":"J Neurol Neurosurg Psychiatry","first-page":"129","article-title":"Accessory middle cerebral artery and Moyamoya disease","volume":"71","author":"Komiyama","year":"2001","unstructured":"Komiyama MYasui T.Accessory middle cerebral artery and Moyamoya disease. J Neurol Neurosurg Psychiatry. 2001;71(1):129-130."},{"issue":"5","key":"bib10","series-title":"Chang Gung Med J","first-page":"541","article-title":"Ruptured aneurysm of the accessory middle cerebral artery associated with Moyamoya disease: a case report","volume":"34","author":"Lee","year":"2011","unstructured":"Lee CCLiu ZHJung SMYang TC.Ruptured aneurysm of the accessory middle cerebral artery associated with Moyamoya disease: a case report. 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Jpn J Stroke. 2013;35(6):457-462."},{"issue":"1","key":"bib12","series-title":"Neuroradiology","first-page":"29","article-title":"Proximal internal carotid artery stenosis associates with diffuse wall thickening in petrous arterial segment of Moyamoya disease patients: a three-dimensional magnetic resonance vessel wall imaging study","volume":"61","author":"Chen","year":"2019","unstructured":"Chen XWang JLiu YProximal internal carotid artery stenosis associates with diffuse wall thickening in petrous arterial segment of Moyamoya disease patients: a three-dimensional magnetic resonance vessel wall imaging study. Neuroradiology. 2019;61(1):29-36."},{"issue":"10","key":"bib13","series-title":"AJNR Am J Neuroradiol","first-page":"1898","article-title":"Clinical significance of the champagne bottle neck sign in the extracranial carotid arteries of patients with Moyamoya disease","volume":"37","author":"Yasuda","year":"2016","unstructured":"Yasuda CArakawa SShimogawa TClinical significance of the champagne bottle neck sign in the extracranial carotid arteries of patients with Moyamoya disease. AJNR Am J Neuroradiol. 2016;37(10):1898-1902."},{"key":"bib14","series-title":"World Neurosurg","first-page":"e253","article-title":"Progressive shrinkage of involved arteries in parallel with disease progression in Moyamoya disease","volume":"122","author":"Yamamoto","year":"2019","unstructured":"Yamamoto SKashiwazaki DAkioka NKuwayama NNoguchi KKuroda S.Progressive shrinkage of involved arteries in parallel with disease progression in Moyamoya disease. 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Brain Res. 2014;1552:64-71."},{"issue":"2","key":"bib21","series-title":"J Stroke","first-page":"65","article-title":"Genetics and biomarkers of Moyamoya disease: significance of RNF213 as a susceptibility gene","volume":"16","author":"Fujimura","year":"2014","unstructured":"Fujimura MSonobe SNishijima YGenetics and biomarkers of Moyamoya disease: significance of RNF213 as a susceptibility gene. J Stroke. 2014;16(2):65-72."},{"issue":"6 Pt 2","key":"bib22","series-title":"Am J Physiol","first-page":"H1145","article-title":"Flow-induced release of endothelium-derived relaxing factor","volume":"250","author":"Rubanyi","year":"1986","unstructured":"Rubanyi GMRomero JCVanhoutte PM.Flow-induced release of endothelium-derived relaxing factor. 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