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This case examines the formation of a twig-like middle cerebral artery after M1 dissection in a child with a KRAS-mutated AVM.

April 10, 2026Open Access

De novo twig-like middle cerebral artery after suspected M1 dissection in early childhood with coexisting KRAS-mutated brain arteriovenous malformation: illustrative case

Key Points

This case examines the formation of a twig-like middle cerebral artery after M1 dissection in a child with a KRAS-mutated AVM.
Case study design with detailed angiographic analysis.
Assessment of cranial vascular anatomy through imaging techniques.
Evaluation of genetic mutations related to vascular remodeling.
Formation of a postnatal twig-like MCA observed following focal M1 injury.
Possibly misclassified as congenital in late angiograms.
Presence of KRAS mutation suggests a potential link to vascular genetic remodeling capabilities.

Abstract

This pediatric case shows that T-MCA can form postnatally after focal M1 injury and may be misclassified as congenital on a single late angiogram. The coexisting KRAS-mutated AVM raises a testable role for somatic vascular genetics in remodeling responses beyond RNF213-focused testing. https://thejns.org/doi/10.3171/CASE2611.

De novo twig-like middle cerebral artery after suspected M1 dissection in early childhood with coexisting KRAS-mutated brain arteriovenous malformation: illustrative case

Key Points

Abstract

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