PMC10069912_01
Left oblique (A) and lateral (B) views of three-dimensional rotational angiography show the anastomosis from the internal maxillary artery to the internal carotid artery (solid arrows). The dashed arrow shows the middle meningeal artery. The solid arrowhead indicates two aneurysms in the internal carotid artery.
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ICA-ophthalmic artery bifurcation, 2) left ICA paraclinoid, 3) left ICA cavernous portion, and 4) left ICA cervical segment. In addition, an ECA-ICA anastomosis had developed on the left side (Fig. 1).
Multiplanar reconstruction image (A: axial, B: sagittal) shows that the anastomotic vessel passes through the foramen ovale (open arrow).
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The anastomotic vessel originated from the internal maxillary artery, was confirmed to pass through the foramen ovale by multiplanar reconstruction (MPR) images, and was determined to be the AMA (Fig. 2).
Multiplanar reconstruction image shows that the ophthalmic artery (open arrowhead) branches off from the internal carotid artery separately from the accessory meningeal artery (open arrow).
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ICA by MPR imaging (Fig. 3). In addition, a severe double flexion of the left ICA cervical portion was observed on cervical DSA (Fig. 4).
Left cervical digital subtraction angiography (A) shows double flexion of the internal carotid artery and an aneurysm (solid arrowhead) on the greater side of the distal flexion. Three-dimensional computed tomography angiography (B) shows close-up images of distal and proximal flexion. Digital subtraction angiography in the early arterial phase (C) and 0.25 seconds later (D) shows that the contrast medium passing through the internal carotid artery reaches the intracranial vessels earlier than the accessory meningeal artery (solid arrows).
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ICA by MPR imaging (Fig. 3). In addition, a severe double flexion of the left ICA cervical portion was observed on cervical DSA (Fig. 4).