• Lydia Gregg, Diego San Millán, Emanuele Orru, Rafael J Tamargo, and Philippe Gailloud.
• *Division of Interventional Neuroradiology, ‡Department of Art as Applied to Medicine, and §Department of Neurological Surgery, The Johns Hopkins Hospital, Baltimore, Maryland; ¶Neuroradiology Unit, Diagnostic and Interventional Radiology Service, Hospital of Sion, Valais, Switzerland.
• Neurosurgery. 2015 Oct 19.

BackgroundBefore the development of the adult ophthalmic artery (OA), the primitive maxillary artery (MA), the primitive dorsal OA, and the primitive ventral OA contribute to the vascularization of early ocular structures, whereas the primitive olfactory artery (OlfA) forms in the vicinity of the optic vesicle. These vessels are involved in several OA origin variants.ObjectiveTo clarify the developmental history of the OA, emphasizing in particular the criteria used to define persistent primitive OAs.MethodsEight rare variants relevant to the discussion of aberrant OA origins are presented.ResultsFive abnormal anatomic configurations are described including (1) OAs branching from the cavernous internal carotid artery (ICA) involving a persistent primitive MA, (2) OAs originating from the distal supraclinoid ICA involving persistent primitive ventral or dorsal OAs, (3) an OA originating from the anterior cerebral artery (ACA) involving a persistent primitive OlfA, (4) a persistent primitive OlfA, and (5) infraoptic ACAs involving the persistent primitive MA, OlfA, and OA.ConclusionDiscrepancies regarding the identification of persistent primitive OAs appear to result from a misinterpretation of the literature. Notably, an OA arising from the cavernous segment of the ICA derives from a primitive MA, whereas an OA arising from the ACA represents the partial persistence of a primitive OlfA; neither corresponds to a persistent primitive OA. Two new observations of this latter variant, which is exceptional, are presented.AbbreviationsACA, anterior cerebral arteryDSA, digital subtraction angiographyICA, internal carotid arteryILT, inferolateral trunkMA, maxillary arteryMMA, middle meningeal arteryMRA, magnetic resonance angiographyOA, ophthalmic arteryOlfA, olfactory arteryPComA, posterior communicating arterySOF, superior orbital fissure.

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