Basilar-middle meningeal artery anastomoses associated with a cerebral aneurysm

Abstract

~" Unique radiographic and autopsy findings are described in a patient with bilateral basilar artery-middle meningeal artery (BA-MMA) anastomoses associated with a ruptured aneurysm of the anterior communicating artery. The literature, anatomy, and embryology of BA-MMA anastomosis is reviewed.KEY WORDS 9 basilar artery 9 cerebral aneurysm 9 carotid artery 9 cerebral arteries 9 meningeal artery 9 vascular anastomosis Address reprint requests to:

Anomalous Origin of the Middle Meningeal Artery from the Posterior Inferior Cerebellar Artery

“…Various sources of anomalous origin of the MMA have been reported in the literature (Table 1). 3–12 Some authors have described the anomalous origin of the MMA from the basilar artery 2–6 . The very first case of MMA origin from basilar artery was reported by Altman in 1947 during the postmortem dissection of a 7‐month old fetus 2 .…”

“…The authors suggested that the territorial supply of the MMA is replaced, at least in part, by the basilar‐middle meningeal anastomosis. Subsequently, in 1981, Katz et al 5 described a patient with cerebral aneurysm and associated basilar‐MMA anastomosis. Most recently, Shah and Hurst 6 described an MMA originating from a large lateral pontine branch of the basilar artery.…”

“…[3][4][5][6][7][8][9][10][11][12] Some authors have described the anomalous origin of the MMA from the basilar artery. [2][3][4][5][6] The very first case of MMA origin from basilar artery was reported by Altman in 1947 during the postmortem dissection of a 7-month old fetus. 2 After the aforementioned anatomical description, Seeger and Hemmer, in 1976, described 3 patients with the first angiographic evidence of left MMA origin from the basilar artery.…”

“…The middle meningeal artery (MMA) is the largest branch of the internal maxillary artery supplying the meninges. Some reported aberrant sources include origin from the third part of the maxillary artery, persistent stapedial artery, ophthalmic artery, internal carotid artery, ascending pharyngeal artery, basilar artery, and lacrimal artery 1–6 . The variations in the origin of the MMA are of clinical importance while dealing with fractures of the base of the skull, epidural hematomas, surgery of the nerve of the pterygoid canal or the Vidian nerve, and during endovascular and surgical interventions of the internal maxillary artery.…”

“…Some reported aberrant sources include origin from the third part of the maxillary artery, persistent stapedial artery, ophthalmic artery, internal carotid artery, ascending pharyngeal artery, basilar artery, and lacrimal artery. [1][2][3][4][5][6] The variations in the origin of the MMA are of clinical importance while dealing with fractures of the base of the skull, epidural hematomas, surgery of the nerve of the pterygoid canal or the Vidian nerve, and during endovascular and surgical interventions of the internal maxillary artery. To the best of our knowledge, ours is the first angiographically documented case of the anomalous origin of the MMA from the posterior inferior cerebellar artery (PICA).…”