Middle Meningeal Origin of the Ophthalmic Artery

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 401-407 ◽  
Author(s):  
Qingliang Liu ◽  
Albert L. Rhoton

Abstract OBJECTIVE To examine the microsurgical anatomy and clinical significance of an anomalous origin of the ophthalmic artery from the middle meningeal artery. METHODS In the course of an anatomic study of the cavernous sinus, an anomalous ophthalmic artery arising from the middle meningeal artery was found. To further define the anatomy of the region, five additional skulls, in which the arteries and veins were injected with colored latex, were dissected using 3× to 40× magnification. RESULTS The anomalous ophthalmic artery arose from the frontal branch of the middle meningeal artery, passed through the superior orbital fissure, and supplied the entire contents of the orbit, as well as giving rise to the central retinal artery. This study provides the first display of this anomaly in an anatomic dissection. CONCLUSION The ophthalmic artery may infrequently arise from the middle meningeal artery. This anomaly places the ophthalmic artery at risk during procedures in which the dura is elevated from the greater and lesser wings of the sphenoid or when the sphenoid ridge is removed and during embolization procedures involving the branches of the external carotid artery.

2007 ◽  
Vol 106 (1) ◽  
pp. 142-150 ◽  
Author(s):  
Paolo Perrini ◽  
Andrea Cardia ◽  
Kenneth Fraser ◽  
Giuseppe Lanzino

Object The authors studied the microsurgical anatomy of the ophthalmic artery (OphA), paying particular attention to its possibly dangerous anastomoses with the middle meningeal artery (MMA). Methods The microsurgical anatomy of the OphA and its anastomoses with the MMA were studied in 14 vessels from seven adult cadaveric heads. The origination order of the OphA branches varies in relation to whether the artery, along its intraorbital course, crosses above or below the optic nerve (ON). The central retinal artery is the first branch to course from the OphA when it crosses over the ON, and it is the second branch to course from the OphA when the artery crosses under the ON. Anastomoses between branches of the MMA and the OphA were present in the majority of the specimens examined. Conclusions Detailed knowledge of the microanatomy of the OphA and recognition of anastomoses between the external carotid artery and the OphA are critically important in avoiding disastrous complications during endovascular procedures.


2003 ◽  
Vol 9 (3) ◽  
pp. 311-314 ◽  
Author(s):  
S. Islam ◽  
H. Manabe ◽  
S. Hasegawa ◽  
A. Takemura ◽  
M. Nagahata ◽  
...  

We describe a rare case of having both symptomatic ipsilateral retinal embolization and asymptomatic cerebellar embolization occurring after carotid stenting with use of distal protect device. In this case, external carotid angiograms revealed accessory meningeal artery-ophthalmic artery and occipital artery-vertebral artery anastomoses. This case suggested that the protection for external carotid artery should be considered during carotid stenting to avoid retinal embolization and cerebellar or cerebral embolization in cases showing angiographical anastomoses between external carotid artery and ophthalmic artery or intracranial arteries.


2015 ◽  
Vol 11 (3) ◽  
pp. E468-E471 ◽  
Author(s):  
Shotaro Yoshioka ◽  
Kazuyuki Kuwayama ◽  
Junichiro Satomi ◽  
Shinji Nagahiro

Abstract BACKGROUND AND IMPORTANCE Intraosseous dural arteriovenous fistulae (DAVF) are rare, especially those with drainage into the diploic venous system. The clinical presentation depends on the location of the lesion. This is the first report of an intraosseous DAVF associated with acute epidural hematoma. CLINICAL PRESENTATION A 25-year-old man presented with headache and nausea. Imaging of the brain revealed abnormal signals indicative of acute epidural hematoma in the right frontal convexity. Angiography demonstrated a DAVF in the region of the frontal bone. Right external carotid artery angiography showed that the DAVF was fed mainly by the right middle meningeal artery with drainage into diploic veins. Immediately after embolization of the middle meningeal and the distal internal maxillary artery with 17% N-butyl-2-cyanoacrylate, the shunt was completely occluded. The patient was discharged 4 days later without clinical complications. CONCLUSION Intraosseous DAVF can be treated by surgical resection or endovascular embolization. Curative treatment requires careful inspection of the angiographic architecture and microsurgical anatomy.


2018 ◽  
Vol 07 (01) ◽  
pp. 012-016 ◽  
Author(s):  
Umesh P Modasiya ◽  
Sanjaykumar Kanani

Abstract Background & Aims: Meningo-orbital foramen is provides a route for an anastomosis between the meningo-orbital branch of the middle meningeal artery and recurrent meningeal branch of ophthalmic artery. Practical importance is emphasized when the middle meningeal artery has abnormal origin, in the cases of subtemporal epidural hematoma, tumors, vascular malformations and in the cases when the foramen spinosum is absent. Present study was undertaken in order to explore the frequency and positional anatomy of this foramen in ninety dry adult human skulls of south Gujarat population. Material & Method: This study was conducted on 90 dry skulls of human origin. Different parameters were noted. Result: Meningo-orbital foramen was absent bilaterally in 35[38.88%] of the skulls studied .The presence of the Meningo-orbital foramen was detected in the 55[61.11%] cases. It was present unilaterally in 30[33.33%] cases [10 on the right and 20 on the left side], and bilaterally in 25[27.77%] cases. Triple MOF were in 2 skulls on right orbit only. Largest variability was noted for distance from the lateral end of the superior orbital fissure. Conclusion: Knowledge of presence and variation in meningo-orbital foramen's anatomical parameter can be crucial for ophthalmologists and neurosurgeons.


1981 ◽  
Vol 55 (6) ◽  
pp. 993-996 ◽  
Author(s):  
Gianni B. Brada ◽  
Johannes Schramm ◽  
Achredt Kaernbach

✓ A case of traumatic exophthalmos due to an arteriovenous fistula between the middle meningeal artery and the veins at the base of the skull is reported. There was no involvement of the cavernous sinus. Embolization following selective transfemoral catheterization of the external carotid artery resulted in complete relief of the symptoms.


2009 ◽  
Vol 65 (suppl_6) ◽  
pp. ons132-ons140 ◽  
Author(s):  
Michael F. Stiefel ◽  
Felipe C. Albuquerque ◽  
Min S. Park ◽  
Shervin R. Dashti ◽  
Cameron G. McDougall

Abstract Objective: An endovascular approach is often the first-line treatment of dural arteriovenous fistulae (DAVFs). Information on the use of Onyx (ev3 Neurovascular, Irvine, CA) for treating DAVFs, however, is limited. Therefore, we present our early experience, technical considerations, and complications associated with the use of Onyx for DAVF embolization. Methods: Twenty-eight patients with 29 DAVFs treated with Onyx embolization were included in this analysis. Hospital records, operative reports, and angiograms were reviewed and analyzed. Results: Forty Onyx procedures, including 39 transarterial and 1 transvenous approaches, were performed. Fifty-one external carotid artery branches, 8 posterior meningeal artery branches, and 3 internal carotid artery branches were used for Onyx embolization. Branches of the middle meningeal artery were embolized 32 times, and the occipital artery was embolized 15 times. Twenty-one fistulae (72%) were cured angiographically with endovascular therapy. Transarterial embolization via the middle meningeal artery cured 12 DAVFs (41%). Four complications (9.7%) were recorded, including 3 transient (7.3%) and 1 permanent neurological deficits (2.4%). Follow-up imaging, which was available for 8 fistulae with angiographic cures, showed no evidence of recurrence. Conclusion: Transarterial Onyx embolization of external carotid artery branches, particularly the middle meningeal artery, offers a high likelihood of cure. This technique provides a safe and effective method of embolization with few side effects and complications. However, long-term follow-up is needed to establish its efficacy.


2017 ◽  
Vol 24 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Flavio Requejo ◽  
Juan Marelli ◽  
Agustin Ruiz Johnson ◽  
Claudia Sampor ◽  
Guillermo Chantada

Background Superselective ophthalmic artery chemotherapy (SOAC) is a proven therapy for the treatment of retinoblastomas. We describe the technique, results and complications of SOAC performed in our hospital. Objective The aim of this article is to demonstrate that a seemingly complex technique can be carried out with a low morbidity rate. Methods A retrospective analysis of patients receiving SOAC in our department from November 2014 to April 2017 was performed. Data collected were age, gender, number of procedures, arteries approached, bilaterality of treatment, and complications. The procedure was performed using a 3F sheath and a flow-dependent 1.5F microcatheter that was navigated from the femoral artery to the ostium of the ophthalmic artery (OA). When the OA was too small or a stable position could not be achieved, the microcatheter was navigated in the external carotid artery to reach an anastomotic ramus (AR) of the middle meningeal artery (MMA) to the OA. The drugs were then injected through the microcatheter in a pulsatile way. Results Forty-one patients underwent SOAC. A total of 248 procedures were performed in 45 eyes, and 248 arteries were approached (205 OAs and 43 MMAs). Four patients underwent tandem therapy (both eyes treated in the same procedure). Complications were: hypotension and bradycardia during the procedure (five cases), transient thrombosis of the femoral artery (two cases), retinal hemorrhage (one case), alopecia (one case), and anaphylactic shock to carboplatin (one case). No patient showed adverse effects of radiation or ischemic stroke. Conclusion SOAC is a safe technique with a very low complication rate.


2016 ◽  
Vol 9 (3) ◽  
pp. e10-e10 ◽  
Author(s):  
Takamitsu Tamura ◽  
David E Rex ◽  
Miklos G Marosfoi ◽  
Ajit S Puri ◽  
Matthew J Gounis ◽  
...  

We describe an interesting case of trigeminocardiac reflex (TCR) caused by selective angiography of the middle meningeal artery (MMA). A 28-year-old woman presented with a symptomatic meningioma. Preoperative tumour embolisation was performed. In the procedure, when selective MMA angiography was done with Omnipaque 300 mg I/mL for 3 mL by manual injection, the patient complained of flashing lights in her eye followed by vomiting and bradycardia down to 40 bpm without increased intracranial pressure signs. On selective MMA angiography, the choroidal crescent and arteries of the periorbital region were opacified by anastomosis from the MMA via the meningo-ophthalmic artery. We diagnosed that her symptoms were caused by selective MMA angiography leading to high pressure stimulation towards the ophthalmic nerve innervation around the orbit as a TCR. We suggest that the operator should be prepared to manage TCR during treatment with expected selective MMA angiography, and gentle low pressure contrast injection should be attempted.


2010 ◽  
Vol 113 (4) ◽  
pp. 936-944 ◽  
Author(s):  
Chang-Ki Kang ◽  
Seung-Taek Oh ◽  
Rack Kyung Chung ◽  
Hyon Lee ◽  
Chan-A Park ◽  
...  

Background Several studies have shown that stellate ganglion block (SGB) is an effective treatment for certain cerebrovascular related diseases; however, the direct effect of SGB on the cerebral vasculature is still unknown. The present study investigated the effect of SGB on the cerebral vascular system using magnetic resonance angiography. Methods Time-of-flight magnetic resonance angiography images of 19 healthy female volunteers (mean ages of 46.4 ± 8.9 yr) were obtained before and after SGB with 1.5-T magnetic resonance imaging. The authors determined successful interruption of sympathetic innervation to the head with the appearance of Horner syndrome and conjunctival injection. We measured changes in the average signal intensity and diameter of the major intracranial and extracranial arteries and their branches, which were presented with mean (±SE). Results The signal intensity changes were observed mainly in the ipsilateral extracranial vessels; the external carotid artery (11.2%, P < 0.001) and its downstream branches, such as the occipital artery (9.5%, P < 0.001) and superficial temporal artery (14.1%, P < 0.001). In contrast, the intensities of the intracranial arteries did not change with the exception of the ipsilateral ophthalmic artery, which increased significantly (10.0%, P = 0.008). After SGB, only the diameter of the ipsilateral external carotid artery was significantly increased (26.5%, P < 0.001). Conclusions We were able to observe significant changes in the extracranial vessels, whereas the intracranial vessels were relatively unaffected (except for the ophthalmic artery), demonstrating that both perivascular nerve control and sympathetic nerve control mechanisms may contribute to the control of intracranial and extracranial blood vessels, respectively, after SGB.


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