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Persistent facial nerve palsy after middle meningeal artery embolization for subdural hematoma: a case report
Ally Ferber1, Yi Zhou2, Brian Greenwald2
1Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, USA.
Objective:
To describe a case of persistent facial nerve palsy after middle meningeal artery (MMA) embolization for chronic subdural hematoma (cSDH).
Methods:
A literature search was conducted for publications within the last 10 years of facial nerve palsy following cerebral circulation embolization procedures.
Results:
With inconsistencies between previously believed pathophysiology and clinical features, other mechanisms causing cSDH such as angiogenesis and capillary formation have been proposed. MMA embolization has evolved as a therapeutic approach to reduce recurrence of subdural hematoma; however, postoperative neural complications such as cranial nerve palsies are poorly described in the literature.
Conclusions:
cSDH is increasingly more common and is on trajectory to become the most prevalent cranial neurosurgical condition. MMA embolization is described as a safe and minimally invasive procedure; however, as a relatively new procedure further research is needed to elucidate associated complications.
Insights
Persistent facial nerve palsy can occur after middle meningeal artery (MMA) embolization for chronic subdural hematoma (cSDH). Further research is needed to understand this rare complication of MMA embolization.
Area of Science:
- Neurosurgery
- Interventional Radiology
Background:
- Chronic subdural hematoma (cSDH) is a common neurosurgical condition.
- Middle meningeal artery (MMA) embolization is an emerging treatment to prevent cSDH recurrence.
- Postoperative neural complications following MMA embolization are not well-documented.
Observation:
- A case of persistent facial nerve palsy after MMA embolization for cSDH is described.
- A literature review identified limited reports on facial nerve palsy after cerebral embolization procedures.
Findings:
- The pathophysiology of cSDH is complex, involving angiogenesis and capillary formation.
- While MMA embolization is considered safe, cranial nerve palsies represent a poorly understood complication.
- Existing literature lacks comprehensive data on neural complications post-MMA embolization.
Implications:
- This case highlights a potential, albeit rare, complication of MMA embolization.
- Increased awareness and further research are necessary to elucidate the mechanisms and management of neural palsies post-embolization.
- Understanding these complications is crucial for refining the safety profile of MMA embolization for cSDH.
