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Many anomalies may involve the ophthalmic and middle meningeal arteries, because of the close relationship of their development. The system of the ophthalmic artery may supply the dural convexity by the middle meningeal artery of ophthalmic origin, the anterior branch of the middle meningeal artery or an accessory meningeal artery. The development and the anatomic arrangement of these anomalous vessels are discussed. Three cases of meningiomas of the brain convexity supplied by anomalous meningeal arteries arising from the ophthalmic artery are described. In one case internal carotid angiography showed an anomalous anterior branch of the middle meningeal artery arising from the ophthalmic artery, whereas the maxillary artery provided only the posterior branch of the middle meningeal artery. In two cases the middle meningeal artery system was normal, but the ophthalmic artery provided an accessory meningeal artery supplying the meningioma. Whereas an ophthalmic origin of the middle meningeal artery is rather common, the angiographic finding of an accessory meningeal artery or an anterior branch of the middle meningeal artery arising from the ophthalmic arterial system is exceptional. The preoperative embolization of dural lesions supplied by anomalous meningeal vessels of ophthalmic origin is dangerous because of the risk of embolization into the ophthalmic circle.
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