副中大脳動脈に関連した脳塞栓症の1例

A case report：cerebral embolism associated with accessory middle cerebral artery

副中大脳動脈（accessory middle cerebral artery：AMCA）は，中大脳動脈における形成異常で，前大脳動脈から分岐しシルビウス裂内を本来の中大脳動脈と並行して走行し，その頻度は0.3～4％といわれている。AMCAに関連する脳塞栓症の報告はまれであり，文献的考察を加え報告する。

We present a case report of cerebral embolism with accessory middle cerebral artery（AMCA）. A 62-year-old man had acute myocardial infarction and received percutaneous coronary intervention（PCI）. Seven days later, he came down with right conjugate deviation, left unilateral spatial neglect and severe left hemiparesis. Some examinations showed cerebral embolism due to right internal cerebral artery（ICA）occlusion. We performed intravenous thrombolysis and mechanical thrombectomy and realized right ICA bifurcation occlusion with right AMCA. Postoperatively his symptoms were free and he discharged on day 15. We need to consider presence of MCA dysplasia such as AMCA in case of a discrepancy between symptoms and imaging findings.