An aplastic or twiglike middle cerebral artery (Ap/T-MCA) is a congenital anomaly related to interference of normal embryonic development of the middle cerebral artery (MCA). This condition may cause ischemic and hemorrhagic strokes as a result of hypoperfusion, vulnerable collateral circulation, and associated aneurysms. We reported a case of Ap/T-MCA with transient ischemic attack, which was successfully treated with revascularization. A 19-year-old woman with a history of transient left upper limb hemiparesis, dysesthesia, and headache visited our hospital.

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