14b above
Pretty much never visible on 2D-DSA. About 10-20% of time visible on high-res Cone Beam CT Angiography (CBCTA). Described by McConnell in his seminal, and still THE BEST, manuscript on pituitary gland arterial supply. See Superior Hypophyseal Artery (14a) and Inferior Hypophyseal Artery (14) pages for pituitary supply. The (Capsular) Artery (arteries) of McConnell pretty much NEVER supply the pituitary though 🙂 They are “osteodural” — supplying the dura of the sella tursica (bottom of it), and adjacent bone. Origin is most commonly from the medial aspect of the horizonal cavernous segment of the ICA. This artery or arteries is a distinct thing. Its not MHT (2) or ILT (3). Occasionally their territory might be supplied by an unusual branch from ILT— weird.
Below is a classic example of “normal” medial cavernous origin
Without arrows
Another typical example — medial horizontal cavernous segment origin — posterior dura and clivus of sella supply (arrows). MHT = dashed arrows; ILT = arrowhead
Yet another example (arrows)
As mentioned above — highly unusual ILT branch, coursing underneath the ICA, and seemingly supplying the dura of the anterior sella. McConnell like?
Coronal MIP
MHT Supply of McConnell Territory
Again, its about the spectrum of possibilities. In this case, the MHT (arrows), in addition to supplying the posterior pituitary, clearly also supplies the ostial and dural elements of the sella turcica, extending prominently to the anterior aspect (dashed arrows)
Movie is best to show
McConnell supply of posterior pituitary
The reverse — McConnell supply of the posterior pituitary — is rare but why not? Does that make it an MHT? Probably not. Classically, that’s what this artery does not do (supply the pituitary) — except when it does. Below is an example (arrows). MHT region contributes to marginal tentorial and clival branches. There is also an ILT. The McConnell origin from medial inferior horizontal cavernous segment is classic — except for pituitary supply.
Stereos
