Stenting for Middle Cerebral Artery Stenosis Associated with a Nonbifurcating Cervical Carotid Artery: Case Report and Naming Consideration.

Abstract

A nonbifurcating cervical carotid artery (NBCCA) is a rare anatomic variation of the carotid artery which directly arises from the common carotid artery without forming a bifurcation. A rare case of an NBCCA associated with middle cerebral artery (MCA) stenosis is reported herein. A 70-year-old man was admitted to the hospital for fresh infarctions in the left frontoparietal lobe. The angiographic imaging showed severe atherosclerotic stenosis in the left MCA associated with an ipsilateral NBCCA. The origin of the left internal carotid artery (ICA) was occluded leaving a stump. A tortuous anastomotic vessel arose from the external carotid artery and continued as the cervical ICA. A stent was placed in the left MCA, and the patient recovered uneventfully and without further ischemia during follow-up. Embryogenesis and naming considerations are briefly discussed. This is the first report of an NBCCA accompanied by ipsilateral MCA stenosis. The name hypogenesis/agenesis of the proximal ICA might describe the congenital anatomic variation of an NBCCA more accurately than NBCCA.