{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T16:27:32Z","timestamp":1780590452284,"version":"3.54.1"},"reference-count":8,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>We present a rare case of a 16-year-old male who was admitted with bilateral tinnitus and subsequently underwent magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) for further evaluation. The left internal carotid (ICA) artery had a normal caliber but ended as a stump at the C7 segment, with a network of filiform vessels from both the stump and right posterior communicating artery (PComm). The right PComm was hypertrophic and the right posterior cerebral artery (PCA) was mainly supplied by the right ICA. The right ICA\u2019s bifurcation and the initial middle cerebral artery (MCA) segment were absent, while the MCA trunk was hypoplastic. The right PCA and pial branches vascularized the temporal lobe, with collaterals between the PCA and MCA. The left ICA was slightly enlarged with double fenestration at the left A1 segment. The right A1 segment of the anterior cerebral artery had double fenestration and while several diagnoses were considered, no single diagnosis fully explained all clinical findings. A thorough review of the existing literature yielded no comparable cases, highlighting the uniqueness of this presentation. This case emphasizes the complexity of cerebral vascular anomalies and the challenges associated with diagnosing such rare conditions, underscoring the need for careful assessment.<\/jats:p>","DOI":"10.3390\/diagnostics15111333","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T03:34:46Z","timestamp":1748316886000},"page":"1333","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Complex Cerebral Artery Anomaly Rete-like Formation of the Terminal Carotid and Middle Cerebral Arteries with Bilateral A1 Segments Fenestrations"],"prefix":"10.3390","volume":"15","author":[{"given":"Dragoslav","family":"Nestorovic","sequence":"first","affiliation":[{"name":"Center for Radiology, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-8230","authenticated-orcid":false,"given":"Igor","family":"Nikolic","sequence":"additional","affiliation":[{"name":"Clinic for Neurosurgery, University Clinical Centre of Serbia, Koste Todorovica 4, 11000 Belgrade, Serbia"},{"name":"Medical Faculty, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrija","family":"Savic","sequence":"additional","affiliation":[{"name":"Clinic for Neurosurgery, University Clinical Centre of Serbia, Koste Todorovica 4, 11000 Belgrade, Serbia"},{"name":"Medical Faculty, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1910-6000","authenticated-orcid":false,"given":"Drazen","family":"Radanovic","sequence":"additional","affiliation":[{"name":"Clinic for Neurosurgery, University Clinical Centre of Serbia, Koste Todorovica 4, 11000 Belgrade, Serbia"},{"name":"Institute for Medical Pharmacology, Dr Subotica Starijeg 1, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Miletic","sequence":"additional","affiliation":[{"name":"Center for Radiology, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7868-7880","authenticated-orcid":false,"given":"Vladimir","family":"Cvetic","sequence":"additional","affiliation":[{"name":"Center for Radiology, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia"},{"name":"Medical Faculty, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1056\/NEJMra0804622","article-title":"Moyamoya disease and moyamoya syndrome","volume":"360","author":"Scott","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ota, T. (2023). Revised concept of rete-like collateral formation: Rete mirabile does not exist in humans. Interv. Neuroradiol., 15910199231221294.","DOI":"10.1177\/15910199231221294"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/j.1552-6569.2007.00092.x","article-title":"Internal carotid aplasia\/hypoplasia and intracranial saccular aneurysms: Series of three new cases and systematic review of the literature","volume":"17","author":"Zink","year":"2007","journal-title":"J. Neuroimaging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s00276-009-0531-x","article-title":"Carotid and vertebrobasilar rete mirabile: A case report","volume":"32","author":"Sahin","year":"2010","journal-title":"Surg. Radiol. Anat."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Chen, H., Hou, K., Wang, X., Xu, K., and Yu, J. (2019). Spontaneous recession of a posterior cerebral artery aneurysm concurrent with carotid rete mirabile and moyamoya-pattern collateral vessels: A case report. BMC Neurol., 19.","DOI":"10.1186\/s12883-019-1277-7"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"261","DOI":"10.2176\/nmc.ra.2017-0043","article-title":"Anomalies of the Middle Cerebral Artery","volume":"57","author":"Uchiyama","year":"2017","journal-title":"Neurol. Med. Chir."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.3174\/ajnr.A4236","article-title":"Fenestrations of intracranial arteries","volume":"36","author":"Bechan","year":"2015","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5797\/jnet.cr.2020-0202","article-title":"Mechanical Thrombectomy for ICA Top Occlusion with Twig-like MCA: A Case Report","volume":"16","author":"Sakai","year":"2022","journal-title":"J. Neuroendovasc. Ther."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/11\/1333\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:40:31Z","timestamp":1760031631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/11\/1333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":8,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["diagnostics15111333"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15111333","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,26]]}}}