Various anastomosis and aberrant origins of the middle meningeal artery (MMA) have been documented in literature. However, there has been no report of its origin from the posterior inferior cerebellar artery (PICA) or its branches. In this report, we discuss an anomalous origin of the MMA from the PICA. Also, we discuss the embryological and anatomical development of the MMA. Imaging identification of the origin of the MMA is important while planning surgical and endovascular interventions in the region of the skull base.

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