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Distribution of the Middle Meningeal Artery Variants in Patients Undergoing Embolization for Chronic Subdural
Sandra A Pilawska1, Magdalena Dębicka1, Roger M Krzyżewski1
1Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland.
Background:
The middle meningeal artery (MMA) is a major dural vessel that plays a significant role in developing chronic subdural hematomas (cSDHs). Understanding its variable anatomy is essential for the effective management of cSDH and the prevention of complications.
Methods:
MMA anatomy was retrospectively assessed in a population of 92 patients who underwent digital subtraction angiography of cerebral vessels before MMA embolization for cSDH.
Results:
We assessed 121 MMAs in 92 patients who underwent digital subtraction angiography for cSDH treatment from October 2020 to July 2023. The most common type in the extended Adachi classification was IC (19.82%) and the rarest was IB (6.31%). The anterior branch of the MMA was the most frequently dominant, while the most common origin of the posterior branch was observed in the distal segment. We reported 4 cases (3.31%) of the MMA arising from the ophthalmic artery.
Conclusions:
The most common configuration of MMA was Adachi-type IC. The MMA most often originated from the maxillary artery. The posterior branch of the MMA was typically dominant and most frequently originated from the distal segment. There was no significant impact of Adachi type on treatment results or fluoroscopy time.
Insights
The middle meningeal artery (MMA) anatomy, crucial for chronic subdural hematomas (cSDH), was studied. Adachi-type IC was most common, with the MMA typically originating from the maxillary artery.
Area of Science:
- Neurointerventional radiology
- Cerebrovascular anatomy
- Neurosurgery
Background:
- The middle meningeal artery (MMA) is a key vessel in the dura mater.
- Its anatomy is critical for managing chronic subdural hematomas (cSDH).
Purpose of the Study:
- To retrospectively analyze the anatomical variations of the MMA in patients undergoing embolization for cSDH.
- To correlate MMA anatomy with treatment outcomes.
Main Methods:
- Retrospective analysis of 121 MMAs in 92 patients.
- Digital subtraction angiography (DSA) was used prior to MMA embolization for cSDH.
- Assessment based on the extended Adachi classification.
Main Results:
- The most frequent MMA type was Adachi-IC (19.82%).
- The MMA most commonly originated from the maxillary artery.
- The posterior branch was typically dominant and originated distally; 3.31% arose from the ophthalmic artery.
Conclusions:
- Adachi-type IC is the most common MMA configuration.
- MMA origin from the maxillary artery is most frequent.
- MMA anatomical variations did not significantly impact treatment results or fluoroscopy time.
