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Unexpected ocular morbidity after middle meningeal artery embolization: Lessons learned from a case of

Ju Tian1

  • 1Department of Burns and Plastic Surgery, Zhongshan City People's Hospital, Zhongshan 528400, Guangdong Province, China. tian-ju@163.com.

World Journal of Clinical Cases
|August 29, 2025
PubMed

Insights

Middle meningeal artery embolization (MMAE) can cause complications due to vessel variations. This study proposes innovations in MMAE safety, including adaptive imaging and hybrid embolization, to improve patient outcomes and reduce risks.

Area of Science:

  • Neurology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Middle meningeal artery embolization (MMAE) is a key treatment for chronic subdural hematoma.
  • Anatomical variations can lead to procedural complications, such as inadvertent embolization of adjacent arteries.
  • Dynamic middle meningeal-ophthalmic anastomoses pose a risk for iatrogenic injury during MMAE.

Discussion:

  • Intraoperative anastomotic unmasking reveals dynamic vascular anomalies missed by preoperative imaging.
  • Hybrid embolization, combining liquid agents and particles, offers improved precision and safety over monotherapy.
  • A 108-day follow-up demonstrated functional recovery, challenging the notion of irreversible cranial nerve injury.

Key Insights:

  • Adaptive imaging protocols are essential to identify dynamic vascular behaviors during MMAE.
  • Multimodal embolic strategies enhance procedural safety and efficacy.
  • Structured, long-term rehabilitation is crucial for optimizing patient outcomes post-MMAE.

Outlook:

  • Procedural agility and multimodal approaches can minimize iatrogenic harm in MMAE.
  • Further research into dynamic anastomoses and tailored rehabilitation protocols is warranted.
  • Establishing standardized follow-up benchmarks can guide clinical practice and improve patient care.
Keywords:
Chronic subdural hematomaFunctional recoveryHybrid embolization strategiesLacrimal artery embolizationMiddle meningeal artery embolization

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