scholarly journals Basilar artery origin of an orbital artery – A rare variant and review of the embryology of the orbital arterial supply

2020 ◽  
Vol 26 (5) ◽  
pp. 668-674
Author(s):  
Pervinder Bhogal ◽  
Cindy Richter ◽  
Stefan Schob ◽  
Muhammad AlMatter ◽  
Victoria Hellstern ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Rare Variant ◽  
Basilar Artery ◽  
Ophthalmic Artery ◽  
External Carotid Artery ◽  
Point Of View ◽  
Arterial Supply ◽  
External Carotid ◽  
First Case

We present a patient with separation of the arterial supply to the globe and the extra-ocular muscles. The ophthalmic artery originates from the typical adult location and supplies only the globe. Arising from the basilar artery was a branch that supplies the extra-ocular muscles. There was no apparent connection between these vessels around the optic nerve and no evidence of supply from the external carotid artery. We discuss the embryology of the ophthalmic artery from the point of view of Padget and Lasjaunias and offer our opinion on the on-going controversy. We believe this is the first case to highlight the trigeminal-primitive maxillary-stapedial anastamotic pathway.

scholarly journals Effect of Stellate Ganglion Block on the Cerebrovascular System

2010 ◽  
Vol 113 (4) ◽  
pp. 936-944 ◽  
Author(s):  
Chang-Ki Kang ◽  
Seung-Taek Oh ◽  
Rack Kyung Chung ◽  
Hyon Lee ◽  
Chan-A Park ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Signal Intensity ◽  
Ophthalmic Artery ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
External Carotid Artery ◽  
External Carotid ◽  
Ganglion Block

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.

Orbital Vascular And Lymphatic Systems

2012 ◽  
Author(s):  
David Jordan ◽  
Louise Mawn ◽  
Richard L. Anderson
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Sympathetic Nerve Fibers ◽  
Carotid Canal ◽  
Cervical Ganglion

The anatomy of the orbital vascular bed is complex, with tremendous individual variation. The main arterial supply to the orbit is from the ophthalmic artery, a branch of the internal carotid artery. The external carotid artery normally contributes only to a small extent. However, there are a number of orbital branches of the ophthalmic artery that anastomose with adjacent branches from the external carotid artery, creating important anastomotic communications between the internal and external carotid arterial systems. The venous drainage of the orbit occurs mainly via two ophthalmic veins (superior and inferior) that extend to the cavernous sinus, but there are also connections with the pterygoid plexus of veins, as well as some more anteriorly through the angular vein and the infraorbital vein to the facial vein. A working knowledge of the orbital vasculature and lymphatic systems is important during orbital, extraocular, or ocular surgery. Knowing the anatomy of the blood supply helps one avoid injury to the arteries and veins during operative procedures within the orbit or the eyelid. Inadvertent injury to the vasculature not only distorts the anatomy and disrupts a landmark but also prolongs the surgery and might compromise blood flow to an important orbital or ocular structure. Upon entering the cranium, the internal carotid artery passes through the petrous portion of the temporal bone in the carotid canal and enters the cavernous sinus and middle cranial fossa through the superior part of the forame lacerum . It proceeds forward in the cavernous sinus with the abducens nerve along its side. There it is surrounded by sympathetic nerve fibers (the carotid plexus ) derived from the superior cervical ganglion. It then makes an upward S-shaped turn to form the carotid siphon , passing just medial to the oculomotor, trochlear, and ophthalmic nerves (V1). After turning superiorly in the anterior cavernous sinus, the carotid artery perforates the dura at the medial aspect of the anterior clinoid process and turns posteriorly, inferior to the optic nerve.

scholarly journals Retinal Embolization and Cerebellar Asymptomatic Embolization after Carotid Stenting Using Distal Balloon Protection

2003 ◽  
Vol 9 (3) ◽  
pp. 311-314 ◽  
Author(s):  
S. Islam ◽  
H. Manabe ◽  
S. Hasegawa ◽  
A. Takemura ◽  
M. Nagahata ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Carotid Stenting ◽  
External Carotid Artery ◽  
External Carotid ◽  
Occipital Artery ◽  
Cerebral Embolization ◽  
Intracranial Arteries ◽  
Balloon Protection ◽  
Meningeal Artery

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.

Angiographic investigation of orbital vascular variations in the rabbit and implications for endovascular intra-arterial chemotherapy models

2020 ◽  
pp. neurintsurg-2020-016460
Author(s):  
Michael T Froehler ◽  
Michael J Feldman ◽  
Bryan Poitras ◽  
Anthony B Daniels
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Zealand White Rabbit ◽  
Small Animal ◽  
External Carotid Artery ◽  
Arterial Supply ◽  
External Carotid ◽  
Superselective Angiography ◽  
Ophthalmic Arteries ◽  
Animal Experimental Model

BackgroundThe New Zealand White rabbit (NZWR) is the first small-animal experimental model of intra-arterial chemotherapy (IAC) for retinoblastoma treatment. The NZWR has dual ophthalmic arteries (OA): the external OA (EOA) arises from the external carotid artery and the internal OA (IOA) from the internal carotid artery. We describe the technique that we have refined for OA catheterization in rabbits, and describe the angioanatomical variations in the OA supply to the NZWR eye and implications for IAC delivery, which were identified as part of a larger project exploring IAC effects in a rabbit retinoblastoma model.MethodsWe developed techniques to perform angiography of the external and internal carotid arteries and superselective angiography of the EOA and IOA in NZWR using transfemoral access and a microwire/microcatheter system. EOA and IOA supply to the eye was determined angiographically and recorded before selective OA catheterization and angiography.Results114 rabbits underwent carotid angiographic evaluation and OA catheterization (161 total eyes evaluated, 112 right, 49 left). Most eyes had a single dominant arterial supply; either IOA or EOA. EOA was dominant in 73% (118/161), and IOA was dominant in 17% (27/161). Co-dominant supply was seen in 10% (16/161). Of the rabbits with bilateral OA catheterization, 25/47 (53%) had bilateral dominant EOA.ConclusionSuccessful catheterization of the OA in the NZWR can be readily accomplished with nuanced technique. The external OA is the dominant arterial supply in the majority of NZWR eyes. These findings allow for successful reproduction of OA catheterization studies of IAC for retinoblastoma in NZWR.

scholarly journals Ophthalmic artery occlusion following neuro-embolization of the external carotid artery, a case report

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Ng Wei Loon ◽  
Balwant Singh Gendeh ◽  
Rozman Zakaria ◽  
Jemaima Che Hamzah ◽  
Norshamsiah Md Din
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Artery Occlusion ◽  
External Carotid Artery ◽  
External Carotid

A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses

2007 ◽  
Vol 106 (1) ◽  
pp. 142-150 ◽  
Author(s):  
Paolo Perrini ◽  
Andrea Cardia ◽  
Kenneth Fraser ◽  
Giuseppe Lanzino
Keyword(s):  
Optic Nerve ◽  
Ophthalmic Artery ◽  
Endovascular Procedures ◽  
Middle Meningeal Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Detailed Knowledge ◽  
Microsurgical Anatomy ◽  
Retinal Artery ◽  
Meningeal Artery

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.

Recurrent retinal ischemia beyond cervical carotid occlusions

1981 ◽  
Vol 55 (4) ◽  
pp. 532-542 ◽  
Author(s):  
Roger W. Countee ◽  
Thurairasah Vijayanathan ◽  
Pamela Chavis
Keyword(s):  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Clinical History ◽  
Retinal Ischemia ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Anticoagulant Drug ◽  
Nonsurgical Patients ◽  
Fine Print

✓ Seventeen patients with persistent amaurosis fugax ipsilateral to angiographically documented internal carotid artery (ICA) occlusions in the neck have been treated by the authors over the past 5 years. Complete cerebral arteriography in each case demonstrated that the symptomatic ophthalmic artery was perfused exclusively by the ipsilateral external carotid artery (ECA), which invariably had an obstructive and/or ulcerative lesion at its origin, and/or an adjacent residual “stump” of the occluded ICA. In nine patients, retinal artery branch emboli were visible on funduscopy. One patient had angiographic evidence of intracranial embolization via the ophthalmic artery from the ECA. Although ipsilateral superficial temporal-middle cerebral artery anastomosis in one patient, and endarterectomy of a contralateral carotid stenosis in another patient, failed to relieve symptoms, endarterectomy of the ECA with resection of the “stump” of the occluded ICA effectively terminated symptoms in 10 of 11 patients. Anticoagulant drug therapy promptly abolished symptoms in four nonsurgical patients as well as in two patients with failed operations. It is concluded that recurrent retinal ischemia beyond cervical carotid occlusions frequently results from microembolism via the ipsilateral ECA. Patients with this mechanism of postocclusion recurrent ischemia can be identified on the basis of clinical history, ophthalmological examinations, and complete cerebral arteriography. Termination of embolic phenomena should be the major treatment goal in these individuals, and ECA endarterectomy is recommended. Anticoagulant drugs are an effective alternative treatment in patients who are poor surgical risks.

Distal Basilar Artery “Umbrella Aneurysm” Treated by Radial Artery Graft Bypass From the External Carotid Artery to Posterior Cerebral Artery and Clip Trapping: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Varadaraya S Shenoy ◽  
Pascal Lavergne ◽  
Zeeshan Qazi ◽  
Basavaraj V Ghodke ◽  
Laligam N Sekhar
Keyword(s):  
Carotid Artery ◽  
Radial Artery ◽  
Cerebral Artery ◽  
Basilar Artery ◽  
Posterior Cerebral Artery ◽  
Video Recording ◽  
Memory Loss ◽  
External Carotid Artery ◽  
External Carotid ◽  
Ct Angiogram

Abstract A 71-yr-old woman was discovered to have an incidental distal basilar artery (BA) fusiform aneurysm 7 × 5 mm in dimension, shaped like an “umbrella handle” with critical stenosis distal to the aneurysm. The right posterior cerebral artery (PCA) P1 segment was small; the left posterior communicating artery (PComA) was miniscule. Because the natural history of fusiform BA aneurysms is poorly defined, this was equated to a saccular aneurysm, with an estimated 10-yr rupture rate of 29%.1-8 After discussion of alternative treatments, the patient decided upon surgery. Because of inadequate collateral circulation, a bypass to the left PCA was deemed necessary.  The aneurysm was exposed by an extended trans-sylvian approach, and the left PCA P2 segment was visualized subtemporally. The left radial artery (RAG) was extracted, and pressure distended to prevent vasospasm. The RAG bypass was sutured first to the P2, and then to the cervical external carotid artery (ECA); the BA aneurysm was then clipped. The proximal anastomosis of the bypass needed revision because of poor flow; a 4-mm punch hole was made to widen the arteriotomy on the ECA. The patient was discharged home with mild memory loss and partial left cranial nerve III palsy. After discharge, she developed a severe left hemicrania, resolved with gabapentin. At 6-wk follow-up, she was asymptomatic, and computed tomography (CT) angiogram demonstrated patency of the bypass.  The patient gave informed consent for surgery and video recording. All relevant patient identifiers have been removed from the video and accompanying radiology slides.

scholarly journals Ophthalmic artery occlusion immediately following placement of a flow diverter without clinical sequelae

2015 ◽  
Vol 21 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Justin R Mascitelli ◽  
Margaret Pain ◽  
Fedor Panov ◽  
Joshua B Bederson ◽  
Aman B Patel
Keyword(s):  
Carotid Artery ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Flow Diverter ◽  
External Carotid Artery ◽  
External Carotid ◽  
Left Internal Carotid Artery ◽  
Collateral Flow ◽  
Vessel Occlusion ◽  
Internal Carotid Artery Aneurysm

Branch vessel occlusion is a potential consequence following flow diverter placement for intracranial aneurysms, but the frequency and clinical impact has not been completely elucidated. In this case of a 45-year-old woman with a large left internal carotid artery aneurysm, the ophthalmic artery was covered by two flow diverters and was acutely occluded along with the aneurysm. Common carotid injections failed to demonstrate collateral flow to the ophthalmic artery via the external carotid artery. Nonetheless, the patient woke from anesthesia with objectively stable and subjectively improved vision. This case demonstrates that an acute occlusion of the ophthalmic artery without external carotid artery collaterals can be tolerated clinically.

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