Normal variants: Posterior meningeal artery origin from the external carotid

The posterior meningeal artery usually originates from one of the vertebral arteries.  It can hypertrophy if it is contributing to dural blood supply of a tumor or arteriovenous malformation. Anomalous origins include the posterior inferior cerebellar artery and the occipital artery.

Case #1

Case #1a

Lateral right common carotid injection

A thin artery (arrow) lies along the inner table of the posterior fossa.  The distal end of this artery goes above the region of the tentorium and thus is extradural and represents a meningeal artery.  The artery probably originates from the occipital artery or one of the deep cervical branches of the ascending pharyngeal artery. 

Case #1b

AP right common carotid injection

Note the thin vertical artery superimposed over the midline (arrows).  Because of its midline position, this artery must be either on the anterior or posterior surface of the calvarium inner table. 

On the AP projection, an artery in this position usually is an anterior falx artery, therefore careful study of the lateral view must be done to determine whether the artery is positioned far anteriorly or far posteriorly.

 
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