PMC4142480_01
Nine-year old girl presented with left-side orbital trauma and third cranial nerve palsy with ptosis later diagnosed with left-side dual ophthalmic arteries with external carotid artery (ECA) and internal carotid artery (ICA) origins. Computed tomography scan shows periorbital soft tissue swelling (black arrow) with retrobulbar stranding in keeping with a small amount of hemorrhage (white arrow).
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F1
Workup computed tomography (CT) scans and magnetic resonance imaging (MRI) revealed probable related trauma with unreliable history, namely left periorbital soft tissue swelling with retrobulbar stranding in keeping with a small amount of hemorrhage and inflammatory change [Figure 1], and also, incidental left cerebellar focal hemorrhage [Figure 2].
Nine-year old girl presented with left-side orbital trauma and third cranial nerve palsy with ptosis later diagnosed with left-side dual ophthalmic arteries with external carotid artery (ECA) and internal carotid artery (ICA) origins. Magnetic resonance image shows left cerebellar focal hemorrhage (black arrow).
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F2
Workup computed tomography (CT) scans and magnetic resonance imaging (MRI) revealed probable related trauma with unreliable history, namely left periorbital soft tissue swelling with retrobulbar stranding in keeping with a small amount of hemorrhage and inflammatory change [Figure 1], and also, incidental left cerebellar focal hemorrhage [Figure 2].
Nine-year old girl presented with left-side orbital trauma and third cranial nerve palsy with ptosis later diagnosed with left-side dual ophthalmic arteries with external carotid artery (ECA) and internal carotid artery (ICA) origins. Left lateral view angiogram of head shows central retinal artery (broken arrow) as a branch of one ophthalmic artery (black arrow) with normal internal carotid artery origin (white arrow).
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F3
An OA with normal origin from the ICA that coursed through the optic foramen presented with the CRA [Figure 3]. Through optic foramen) with a distinct branching pattern, namely terminal branches (i.e. supratrochlear and nasal branches) and ocular branches (i.e. ciliary and muscular branches), as well as the CRA (as witnessed by choroidal blush) were observed [Figure 3]. The left-side vertebral artery followed normal anatomy.
Nine-year old girl presented with left-side orbital trauma and third cranial nerve palsy with ptosis later diagnosed with left-side dual ophthalmic arteries with external carotid artery (ECA) and internal carotid artery (ICA) origins. Left antero-posterior view angiogram of head shows meningoophthalmic artery anomaly (black arrow) and ophthalmic artery variant (white arrow) with external carotid system origin.
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F4
An OA variant with M-OA origin via the maxillary artery (MA) from the ECA coursed through the superior orbital fissure [Figure 4]. The M-OA consisted of an MMA (course: Through the foramen spinosum) with normal branches (i.e. anterior and posterior branches) and an OA variant (course: Through superior orbital fissure) with a distinct branching pattern, namely supraorbital, lacrimal, and ethmoidal branches [Figures 4 and 5].
Nine-year old girl presented with left-side orbital trauma and third cranial nerve palsy with ptosis later diagnosed with left-side dual ophthalmic arteries with external carotid artery (ECA) and internal carotid artery (ICA) origins. Left lateral view angiogram of head shows ophthalmic artery variant (black arrow) and meningo-ophthalmic artery anomaly (white arrow). The ophthalmic artery with internal carotid artery origin (broken arrow) is visible because of injected external carotid artery overflow.
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F5
A lateral view angiogram illustrated both OAs, caused by overflow of the injected ECA [Figure 5]. The M-OA consisted of an MMA (course: Through the foramen spinosum) with normal branches (i.e. anterior and posterior branches) and an OA variant (course: Through superior orbital fissure) with a distinct branching pattern, namely supraorbital, lacrimal, and ethmoidal branches [Figures 4 and 5].