Bilateral carotid-anterior cerebral artery anastomoses associated with bilateral ophthalmic arteries arising from the middle meningeal arteries diagnosed by magnetic resonance angiography: a case report.

Anastomosis between the ophthalmic segment of the internal carotid artery and the A1-A2 junction of the anterior cerebral artery (ACA), described as carotid-ACA anastomosis or infraoptic course of the ACA, is rare and known to demonstrate right-sided predominance. We report a case of bilateral carotid-ACA anastomoses associated with bilateral ophthalmic arteries arising from the sphenoidal branch of the middle meningeal artery that were diagnosed by magnetic resonance (MR) angiography. Identification of rare arterial variations on MR angiography requires careful scrutiny of source images.