title: Ophthalmic systems completely supplied from dural arteries indicate the utility of endovascular treatment of cerebral aneurysms.
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.
authors.affiliation: Department of Neurosurgery, Kameda Medical Center, Kamogawa, Chiba, Japan kadosan0313@ybb.ne.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kadooka
authors.affiliation: Department of Neurosurgery, Kameda Medical Center, Kamogawa, Chiba, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D054893:Cone-Beam Computed Tomography; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D005123:Eye / Q000098:blood supply*; D006801:Humans; D033162:Incidental Findings; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008576:Meningeal Arteries / Q000000981:diagnostic imaging*; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Ophthalmic artery; cone beam computed tomography; endovascular treatment; middle meningeal artery; recurrent meningeal artery