Case #1a
Lateral internal carotid angiogram
The persistent stapedial artery arises from the proximal internal carotid artery and ends as the middle meningeal artery. The middle meningeal artery anastomoses with the ophthalmic artery in this case.
Case #1b
AP internal carotid angiogram
Connection between the persistent stapedial artery, middle meningeal artery, and ophthalmic artery is again demonstrated. When the middle meningeal artery arises in this manner, it does not enter the skull base in the usual fashion. On CT, the foramen spinosum can be small and the geniculate fossa enlarged.