Article ID: 11297
An 82-year-old woman presented with speech difficulties. She had previously undergone surgery for bladder cancer and was independent before stroke onset. Neurological examination revealed sensory aphasia without limb paralysis (NIHSS score 5). Head CT showed low-density areas in the left temporal and parietal lobes. CT angiography suggested occlusion of the left ICA, but part of the left MCA was visualized via the anterior communicating artery (AcomA). DSA showed a thrombus-filling defect at the left distal ICA. The vessels visualized on left ICA angiography differed from those on right ICA angiography via the AcomA, leading to the diagnosis of cerebral infarction due to duplicated MCA. She was treated conservatively without thrombectomy, but the infarct lesion enlarged. She was diagnosed with cancer-associated thrombosis due to bladder cancer recurrence and was transferred to a long-term care hospital with an NIHSS score of 27. Duplicated MCA is a rare vascular anomaly, making diagnosis during occlusion challenging. We discussed the indications for mechanical thrombectomy along with a literature review of MCA anomalies.
