Circulatory variations of the ophthalmic artery.

A 22-year-old right-handed man had a 5 year hi story of prog ressive right-sided weakn ess with loss of use of hand function. There was no history of headache or seizures. Physical examination disclosed increased tone and a Babinsk i sign on the right side. Optic pallor was noted in the left fundu s. A bilateral carotid arteriog ram and a left vertebral arteriog ram revealed a large intracranial arteriovenous malformation (AVM) supplied by multiple branches of the intern al carotid and posterior cerebral arteries (figs. 1 A and 1 B) . The internal carotid artery stud y failed to opacify any part of the ophthalmic artery. External carotid angiog raphy demonstrated filling of the ophthalmic artery from the meningolac rimal artery via the middle meningeal artery (figs. 1 C and 1 D) . A choroidal blush was seen (fig . 1 E) . Flow proceeded retrog radely in th e ophthalmic artery to supply th e malformation. The arterial dynamics thus represented a steal from the ophthalmic artery c irculation by the intracranial AVM .