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AJNR - American Journal of Neuroradiology

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The Ascending Pharyngeal Artery: Branches, Anastomoses, and Clinical Significance

Lotfi Hacein-Bey^a,b, David L. Daniels^a, John L. Ulmer^a, Leighton P. Mark^a, Michelle M. Smith^a, James M. Strottmann^a, Douglas Brown^a,b,c, Glenn A. Meyer^b and Phillip A. Wackym^c

^a Division of Neuroradiology, Department of Radiology, Medical College of Wisconsin
^b Department of Neurological Surgery, Medical College of Wisconsin
^c Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin

View larger version (72K): [in a new window]   FIG 1. A and B, Anteroposterior (A) and lateral (B) angiograms depict rare instances of the ascending pharyngeal artery arising from the internal carotid artery.

View larger version (72K): [in a new window]   FIG 2. Diagram of the two major trunks of the ascending pharyngeal artery: anteriorly, the extracranial pharyngeal trunk; posteriorly, the neuromeningeal trunk, which is intracranial and enters the posterior fossa through the foramen magnum.

View larger version (65K): [in a new window]   FIG 3. Angiogram (A) and diagram (B) of the superior, middle, and inferior pharyngeal branches supplying the pharyngeal submucosal spaces.

View larger version (70K): [in a new window]   FIG 4. Diagram of the lateral view of the hypoglossal and jugular branches, the two main divisions of the neuromeningeal trunk. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (70K): [in a new window]   FIG 5. View from above the hypoglossal and jugular branches. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (50K): [in a new window]   FIG 6. Angiogram (A) and diagram (B) of the odontoid arch system that gives rise to several branches that supply the first, second and third cervical roots and the periosteum of the spinous processes and pedicles. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (54K): [in a new window]   FIG 7. Angiogram (A) and diagram (B) of the inferior tympanic artery arising as a separate branch between the pharyngeal and neuropharyngeal trunks. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (39K): [in a new window]   FIG 8. Diagram depicting ascending pharyngeal artery anastomoses.

View larger version (52K): [in a new window]   FIG 9. Angiogram (A) and diagram (B) of the ascending pharyngeal artery communication with the internal carotid artery to the lateral clival branch of the jugular artery.

View larger version (102K): [in a new window]   FIG 10. Angiogram (A) and diagram (B) of the ascending pharyngeal artery anastomoses to the vertebral artery via the hypoglossal branch and musculospinal branch. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (102K): [in a new window]   FIG 11. Angiogram (A) and diagram (B) of anastomoses to the occipital artery via the odontoid arch. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (58K): [in a new window]   FIG 12. Angiogram (A) and diagram (B) of C1-C2 anastomoses to the occipital artery via the common trunk. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (58K): [in a new window]   FIG 13. Angiogram (A) and diagram (B) of anastomoses via the pterygovaginal artery to the accessory meningeal artery. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (127K): [in a new window]   FIG 14. Angiogram (A) and diagram (B) of the ascending pharyngeal artery supplying a meningioma. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.

View larger version (127K): [in a new window]   FIG 15. Angiogram (A) and diagram (B) of the ascending pharyngeal artery supplying a glomus jugulare tumor. Top, superior view; bottom, inferior view; left, anterior view; right, posterior view.