It aims to highlight the importance of anatomical variations of the (MMA) middle meningeal artery's origin in practice for neurointerventionalist. Before proceeding with embolization of the MMA in some pathologies, a critical analysis of the anatomy of these vessels should be done. When MMA originates from the ophthalmic artery, it is a formal contraindication to proceed with the embolization.11 Bonasia S, Smajda S, Ciccio G, Robert T. Middle Meningeal Artery: Anatomy and Variations. AJNR Am J Neuroradiol 2020;41(10):1777–1785. Doi: 10.3174/ajnr.A6739
https://doi.org/10.3174/ajnr.A6739...
,22 Liu Q, Rhoton AL Jr. Middle meningeal origin of the ophthalmic artery. Neurosurgery 2001;49(02):401–406, discussion 406–407. Doi: 10.1097/00006123-200108000-00025
https://doi.org/10.1097/00006123-2001080...
Otherwise, major complications is embolization of the central retinal artery results in blindness.33 Fantoni M, Eliezer M, Serrano F, et al. High frequency of ophthalmic origin of the middle meningeal artery in chronic subdural hematoma. Neuroradiology 2020;62(05):639–644. Doi: 10.1007/s00234-020-02363-6
https://doi.org/10.1007/s00234-020-02363...
A patient with recurrent chronic subdural hematoma and thrombocytopenia was referred to embolization of the MMA. Angiogram shows MMA originates in the OA, and the procedure was inadvisable (Figures 1 and 2).
References
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1Bonasia S, Smajda S, Ciccio G, Robert T. Middle Meningeal Artery: Anatomy and Variations. AJNR Am J Neuroradiol 2020;41(10):1777–1785. Doi: 10.3174/ajnr.A6739
» https://doi.org/10.3174/ajnr.A6739 -
2Liu Q, Rhoton AL Jr. Middle meningeal origin of the ophthalmic artery. Neurosurgery 2001;49(02):401–406, discussion 406–407. Doi: 10.1097/00006123-200108000-00025
» https://doi.org/10.1097/00006123-200108000-00025 -
3Fantoni M, Eliezer M, Serrano F, et al. High frequency of ophthalmic origin of the middle meningeal artery in chronic subdural hematoma. Neuroradiology 2020;62(05):639–644. Doi: 10.1007/s00234-020-02363-6
» https://doi.org/10.1007/s00234-020-02363-6
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Publication Dates
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Publication in this collection
13 May 2024 -
Date of issue
2024
History
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Received
27 Jan 2024 -
Reviewed
16 Feb 2024 -
Accepted
22 Feb 2024