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Anomalous course of the intracranial internal carotid artery into the orbit: case report
  1. Spiros L Blackburn1,
  2. Mark Dannenbaum1,2,
  3. Albert J Schuette1,
  4. Jacques Dion2
  1. 1Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
  2. 2Department of Neurointerventional Radiology, Emory University, Atlanta, Georgia, USA
  1. Correspondence to Dr Spiros L Blackburn, Department of Neurosurgery, Emory University, Atlanta, Georgia, USA; spirosblackburn{at}


In this report, a case of anomalous internal carotid artery looping into the orbital apex is presented. The patient was a 41-year-old man with sudden onset headache, suggestive of aneurysmal subarachnoid hemorrhage (SAH). Imaging with CT demonstrated a perimesencephalic distribution of blood. Cerebral angiography confirmed non-aneurysmal, perimesencephalic SAH, but incidentally noted an anomalous left internal carotid artery with a course into the orbital cone. This is the only known example of this anatomic variation. Potential embryological explanations are discussed.

  • Congenital
  • artery

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.