Ophthalmic artery origin from middle meningeal artery

Findings:
Lateral common carotid arteriogram shows no identifiable ophthalmic artery in its expected origin from the internal carotid artery. A vessel courses anteriorly from the middle meningeal artery which represents the aberrant opthalmic artery. Note that the middle meningeal artery is larger than expected, especially the anterior branch.

Discussion:
The ophthalmic artery is usually the first branch of the supraclinoid ICA, and is recognized by its anterior course and choroidal blush. Rarely, the ophthalmic artery may arise from the middle meningeal artery, other ECA branches, or proximal cavernous ICA. These important anatomic variants should be kept in mind when embolization in the ECA territory is considered.

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