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Inservice Question (2009)
Q: Which of the following vessels typically arises from the intradural internal carotid artery?
A:
A. Ophthalmic artery B. Trigeminal artery C. Artery of the foramen rotundum D. Vidian artery E. Meningohypophyseal artery
A: A. Ophthalmic artery The ophthalmic artery is usually the first branch to arise from the internal carotid artery beyond the dural ring. B. Trigeminal artery (embryologic variant) C. Artery of the foramen rotundum (typically a branch of the inferolateral trunk) D. Vidian artery (sometimes arises directly from petrous ICA) E. Meningohypophyseal artery (C5 branches)
There are four parts of the ICA
Cervical
Petrous
Cavernous
Supraclinoid
The cavernous and supraclinoid portions are called the “carotid siphon"
Petrous Branches
Trigeminal (embryologic variant)
Mandibulovidian artery(may be mandibular and vidian separately)
Cavernous branches
The are different ways to name the branches, we use the system that the Berenstein service uses (i.e. C4 and C5)
meningohypophyseal trunk (C5 branches) residents may be asked about the tentorial artery or so-called artery of "Bernasconi and Cassinari" that supplies meningiomas and dural fistulas
inferolateral trunk (C4 branches) http://neuroangio.org/anatomy-and-variants/inferolateral-trunk/
http://www.ajnr.org/content/20/6/1061.full (The last two authors were fellows of Alex) these branches are potential anastomoses with the ECA. These "dangerous" anastomoses can be the cause of complications sucha as stroke and blindness for those performing embolization of the head and neck.
Alex Berenstein calls these inferolateral trunk branches the “foot of the chicken”
Anteromedial branch
Artery of the Foramen rotundum (collateral to internal maxillary)
Foramen ovale branch (collateral to accessory meningeal, a branch of the internal maxillary a.)
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