Ischemic alopecia as a complication from therapeutic embolization of the middle meningeal artery

Selective endovascular embolization using microspheres is a widely used, relatively low-risk procedure to control intracranial bleeding. Side effects such as cranial nerve palsies and stroke have been reported in the literature. Skin necrosis and alopecia are exceedingly rare complications of endovascular embolization with a reported incidence of less than 1%. We report a case of a 55-year-old female who developed alopecia following a therapeutic embolization of the middle meningeal artery using microspheres. The clinical-histopathologic diagnosis and relevant literature are reviewed.