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Check out the case of this patient with a torcular dural AVF treated by Eytan Raz (NYU Langone Medical Center).
This images are taken from a diagnostic angiogram performed in a patient with a torcular dural AVF.
As part of the complete angiographic exploration, the ascending pharyngeal artery was selectively catheterized; the images demonstrate the anatomy of the ascending pharyngeal artery supplying the pharynx with its pharyngeal trunk, the meninges through the neuromeningeal trunk and the muscles along the posterior neck form direct proximal horizontal branches.
The image demonstrates beautifully the anastomotic "dangerous" connections of the APHA with the vertebral artery: horizontally through the muscular branch and from above via the odontoid arcade from the hypoglossal division of the neuromeningeal trunk.
Also the "dangerous" connection with the internal carotid artery is well demonstrated via the carotid branch of the APHA which runs in the foramen lacerum, better seen in the dynaCT; an additional connection with the internal carotid artery is shown coming from the neuromeningeal trunk with the clival branch running cranially to merge with the clival branch coming from the meningohypophyseal trunk.
Finally, the APHA gives off the pterygovaginal artery in hemodynamic balance with the sphenopalatine brach of the distal external carotid artery.
