Anomalous Origin of the Ophthalmic Artery From the Anterior Cerebral Artery -Case Report-

Abstract

Fig. 1 T 1 -weighted magnetic resonance images with contrast medium revealing a well-enhanced mass in the left tentorium, cavernous sinus, and suprasellar region. AbstractA 39-year-old woman presented with left visual disturbance and diplopia. Magnetic resonance imaging revealed a well-enhanced tumor in the left tentorium, cavernous sinus, and suprasellar region. Angiography demonstrated an abnormal origin of the ophthalmic artery from the anterior cerebral artery. The tumor was partially removed by left frontotemporal craniotomy with orbitozygomatic osteotomy. Intraoperatively, the anomalous origin of the ophthalmic artery was confirmed. This anatomical variation is extremely rare.

Different ophthalmic artery origins: Embryology and clinical significance

“…Excellent embryological explanations for variants exist, but discrepancies are encountered and some explanations remain speculative at best. Li et al (2011) found in their study a female predominance of 77.78% (14 cases) and a unilateral appearance of 88.89% (16 cases), but no right-side or left-side prevalence (ratio 9:8). Eighteen cases of OA variations were reported between 1969 and 2010 (Li et al, 2011), namely with origins from middle meningeal artery (MMA) (10 cases); basilar artery (BA) (2 cases); anterior cerebral artery (ACA) (3 cases); posterior communicating artery (PcomA) (2 cases); and ICA bifurcation (1 case).…”

“…Double OA origin. OA origins at the bifurcation of the ICA (Hamada et al, 1991) or from the terminal branches of the ICA, namely the A1 segment of the ACA (Hassler et al, 1989;Islak et al, 1994;Li et al, 2011;Hannequin et al, 2013), and the M1 segment of the MCA (Weinberg et al, 1981) are reported. Double origins from the ICA may be from the C3 (lacerum) segment and C4 (carotid siphon) segment that correspond to nonmigration of the PVOA and migration of the PDOA (Lasjaunas, 1981;Ogawa, 1990), respectively, or from the carotid siphon corresponding to normal migration of the PVOA (supracavernous ICA siphon) and the presence of an ILT (proximal remnant of the PDOA from horizontal part of carotid siphon) (Padget, 1948;Kam et al, 2003).…”

“…Extremely rarely, both PDOA and PVOA may persist as dual OAs from the ICA (Hiura, 1980;Ogawa et al, 1990;Islak et al, 1994;Rhoton, 2002;Kam et al, 2003;Uchino et al, 2013b). A logical explanation may be that the OA originate from the ACA as a result of persistence of the PVOA and atrophy of the PDOA (Pichard et al, 1975;Li et al, 2011). Kam et al (2003) reported among their three cases with double OA origin from the ICA that two cases had had PDOA and PVOA anastomoses, while all three cases had had orbital anastomoses.…”

“…In a clinical setting, vascular imaging contributed to clarifications of embryological explanations (Padget, 1948;Lasjaunias et al, 1977a). Eighteen cases of OA variations were reported between 1969 and 2010 (Li et al, 2011), namely with origins from middle meningeal artery (MMA) (10 cases); basilar artery (BA) (2 cases); anterior cerebral artery (ACA) (3 cases); posterior communicating artery (PcomA) (2 cases); and ICA bifurcation (1 case). Li et al (2011) found in their study a female predominance of 77.78% (14 cases) and a unilateral appearance of 88.89% (16 cases), but no right-side or left-side prevalence (ratio 9:8).…”

An update on the variations of the orbital blood supply and hemodynamic

“…This variation has been frequently explained with the persistence of the PVOA [3, 4, 26, 28, 37, 63], though it more probably involves a persistent recurrent POlfA (Fig. 3) [18].…”