Impact of anomalous origin of the ophthalmic artery from the middle meningeal artery on selection of surgical approach to skull base meningioma

Abstract

Background: Ectopic sites of origin of the ophthalmic artery from the MMA are associated with visual complications of surgery directed along the sphenoidal wing or embolization of the MMA.

Case description: Three cases of skull base meningioma in which retinal blood supply originated from the MMA are presented. In one case, the patient experienced transient blindness during selective angiography of the external carotid artery. Because surgical obliteration of the MMA might have caused visual impairment due to sacrifice of the collateral branches from the MMA to the retina during a skull base approach, we selected an approach not involving the MMA.

Conclusions: In a case in which retinal blush is observed from the MMA on selective angiography of the ECA, we should select an appropriate surgical approach to avoid visual complications in cranial base surgery, taking into account a retinal blood supply.