Choroidal Infarction after Embolization of Arteriovenous Fistula of Middle Meningeal Artery

Wang, A. G.; Liu, J. H.; Hsu, Wen-Ming; Luo, Chao-Bao; Yen, May-Yung

doi:10.1097/00006982-200005000-00040

Cited by 7 publications

(3 citation statements)

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“…In another instance, in 2000, Wang et al reported a patient with a DAVF in the cavernous sinus that was supplied by the MMA. A choroidal infarction was observed after an embolization of the DAVF was performed through the MMA, and it was caused by the migration of the embolization agent from the MMA to the ophthalmic artery 29 . Hence, more caution should be taken when evaluating these variant collaterals, and careful angiographic monitoring and slow injection of embolization materials may help to prevent these complications.…”

Section: Pathway For the Embolization Of Davfsmentioning

confidence: 99%

Clinical importance of the middle meningeal artery: A review of the literature

Yu¹,

Guo²,

Xu³

et al. 2016

Int. J. Med. Sci.

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The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases. However, no systematic review describing the importance of MMA has been published. In this study, we used the PUBMED database to perform a review of the literature on the MMA to increase our understanding of its role in neurosurgery. After performing this review, we found that the MMA was commonly used to access DAVFs and meningiomas. Pseudoaneurysms and true aneurysms in the MMA can be effectively treated via endovascular or surgical removal. In MMD, the MMA plays a very important role in the development of collateral circulation and indirect revascularization. For recurrent CDSHs, after burr hole irrigation and drainage have failed, MMA embolization may be attempted. The MMA can also contribute to the occurrence and treatment of migraines. Because the ophthalmic artery can ectopically originate from the MMA, caution must be taken to avoid causing damage to the MMA during operations.

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Section: Pathway For the Embolization Of Davfsmentioning

confidence: 99%

Clinical importance of the middle meningeal artery: A review of the literature

Yu¹,

Guo²,

Xu³

et al. 2016

Int. J. Med. Sci.

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“…A similar condition has been documented in the literature where choroidal infarction was noticed after an embolization of DAVF via the MMA. This complication was later attributed to the migration of the embolic agent from the MMA to the ophthalmic artery ( 36 ). Hence, clinicians should be aware of this when evaluating these anomalous collaterals.…”

Section: Discussionmentioning

confidence: 99%

Anomalous branching of the middle meningeal artery from the basilar artery: a systematic review

Salman,

Mallah,

Almadi

et al. 2024

Front. Neurol.

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BackgroundAnomalous origin of the middle meningeal artery (MMA) from the basilar artery is a rare congenital neurological variant that has been detected in both children and adults with diagnoses ranging from intracranial haemorrhage to ependymoma. This review aims to investigate the anatomical course of an anomalous basilar-middle meningeal artery and its clinical presentation.MethodsA systematic search was performed in PubMed using the keywords (middle meningeal artery) and (basilar artery). Ninety-four papers were identified, of which seven were included. One paper was further identified through cross-referencing.ResultsThe average age of presentation was 43 years with a male predominance (7/9). In most cases, the MMA arose between the superior cerebellar artery and the anterior inferior cerebellar artery (8/9) (versus 1 case between the anterior inferior cerebellar artery and the posterior inferior cerebellar artery). The anomaly mostly presented on the left side (6/11), but was bilateral in one case. Most of the cases showed a pontine artery branching from the basilar artery arising 5 mm to 10 mm proximal to the superior cerebellar artery, which would then assume the trajectory of the MMA. In three cases, the vessel increased in calibre near the trigeminal ganglion. Foramen spinosum absence in the anomalous side was noted in 3/6 of the patients.ConclusionTo avoid unexpected complications during neurosurgical and neuroradiointerventional procedures, it is essential to have a clear understanding of the anomalous routes of the MMA. This is especially important when it proves to be the only available route for embolization.

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“…[ 13 , 15 , 30 , 37 , 40 ] Embolization in these cases may lead to retinal or cranial nerve ischemic injury. [ 23 , 38 , 40 ] Thus, consideration of this technique as an alternative to conservative management assumes an acceptably low procedural complication rate at any given center. Randomized, controlled studies comparing embolization and conservative management could be considered for borderline surgical cases within acceptable clinical parameters.…”

Section: Discussionmentioning

confidence: 99%

Traumatic epidural hematoma treated with endovascular coil embolization

Madison¹,

Graupman

Carroll³

et al. 2021

Surgical Neurology International

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Background: Traumatic cerebrovascular injury may result in epidural hematoma (EDH) from laceration of the middle meningeal artery (MMA), which is a potentially life-threatening emergency. Treatment ranges from surgical evacuation to conservative management based on a variety of clinical and imaging factors. Case Description: A 14-year-old male presented to our institution after falling from his bicycle with traumatic subarachnoid hemorrhage and a right frontotemporal EDH. The patient did not meet criteria for surgical evacuation and endovascular embolization of the right MMA was performed. Rapid resolution of the EDH was observed. Conclusion: This case corroborates the sparse existing literature for the potential role of endovascular embolization to treat acute EDH in carefully selected patients who do not meet or have borderline indications for surgical management.

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Choroidal Infarction after Embolization of Arteriovenous Fistula of Middle Meningeal Artery

Cited by 7 publications

References 0 publications

Clinical importance of the middle meningeal artery: A review of the literature

Clinical importance of the middle meningeal artery: A review of the literature

Anomalous branching of the middle meningeal artery from the basilar artery: a systematic review

Traumatic epidural hematoma treated with endovascular coil embolization

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