Type 2 persistent primitive olfactory artery associated with bilateral ophthalmic arteries arising from the middle meningeal arteries diagnosed by magnetic resonance angiography.

Persistent primitive olfactory artery (PPOA) is a relatively rare variation of the proximal anterior cerebral artery (ACA). Traditionally, there are two types: Type 1 is a common type, which generally follows an anteroinferior course and which takes a hairpin turn before continuing to the A2 segment of the ACA. Type 2 is an extremely rare variation that continues to the anterior ethmoidal artery without a hairpin turn. Since Type 2 PPOAs are small in caliber, previously reported cases were found during anatomical dissection or were detected by catheter angiography. We herein report a case of Type 2 PPOA that was diagnosed by partial-maximum-intensity projection images of magnetic resonance angiography. This patient also had bilateral ophthalmic arteries arising from the middle meningeal artery. These two variations may be related to each other.