Acute ischemic stroke in a twig-like middle cerebral artery: A case report and review of etiology and thrombectomy risks

This case report highlights challenges in diagnosing and managing acute ischemic stroke with Ap/T-MCA. Because complex vascular anatomy may suggest M1 occlusion on non-invasive imaging, MT may lead to interventions with high hemorrhagic risk. Caution is warranted when apparent M1 occlusion coexists with a complex network typical of Ap/T-MCA. Understanding the angiographic features and recognizing the potential risks of MT are essential to optimizing outcomes. Further studies are required to establish appropriate management strategies for acute stroke in this rare vascular anomaly.