Ophthalmic systems completely supplied from dural arteries indicate the utility of endovascular treatment of cerebral aneurysms. Issue 6 (December 2015)

• Record Type: Journal Article
• Authors: Kadooka, Keisuke; Tanaka, Michihiro
• Is Part Of: Interventional neuroradiology. Volume 21:Issue 6(2015:Dec.)
• Page Start: 765
• Page End: 768
• Publication Date: 2015-12
• Subjects: Ophthalmic artery -- middle meningeal artery -- cone beam computed tomography -- endovascular treatment -- recurrent meningeal artery; Nervous system -- Interventional radiology -- Periodicals; Nervous system -- Radiography -- Periodicals; Nervous System Diseases -- Periodicals -- radiography; Neuroradiography -- Periodicals; Radiography, Interventional -- Periodicals; Nervous system -- Radiography; Periodicals; 617.4805
• DOI: 10.1177/1591019915609168
• Languages: English
• ISSNs: 1591-0199

Abstract

We report a 67-year-old man who harboured an unruptured left basilar-superior cerebellar artery aneurysm. Cerebral angiography and cone beam computed tomography with diluted contrast medium showed that the bilateral ophthalmic arteries were not supplied from internal carotid arteries but, rather, were supplied from the middle meningeal and accessory meningeal arteries. This meant that the ophthalmic system was predominantly supplied from the dural arteries and, therefore, pterional craniotomy might cause a compromise in blood supply to the retinal artery. To avoid this complication, coil embolization was selected instead of neck clipping, and this endovascular therapy succeeded without neurological deficit. This case report shows the importance of cerebral angiography (including cone beam computed tomography) and consideration of the patterns of ophthalmic artery perfusion when selecting operative procedures for management of aneurysms that require manipulation around the sphenoid ridge.