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Published on: September 25, 2009
Middle meningeal artery embolization for migraine: A review
Deborah Boyett1, Nadine Marie Khoury1, Nathan Shlobin1
1Department of Neurological Surgery, Columbia University Irving Medical Center, Columbia University, New York, United States.
Background:
Migraine and chronic headaches are highly prevalent disorders representing billions in healthcare spending and significantly reduced quality of life. The middle meningeal artery (MMA) is an established target in intracranial pathologies, and MMA embolization may be an innovative and promising therapeutic approach in the management of chronic headaches.
Methods:
This review of the literature aims to provide an in-depth analysis of the current state of knowledge regarding the effectiveness, safety, and potential implications of surgical targeting of the MMA, with particular emphasis on MMA embolization in the treatment of migraines and chronic headaches. PubMed was systematically queried for studies of MMA Embolization for the treatment of headache.
Results:
The trigeminovascular system is uniquely implicated in the pathogenesis of migraine headaches. Significant improvement in symptoms has been shown when targeting the neural, chemical, and vascular components of this system. The MMA has demonstrated unique behavior during and after migraines, distinct from that of other intracranial vessels. Reports of MMA perturbance have demonstrated prolonged improvements in migraine-induced pain without major adverse effects.
Conclusion:
The MMA's unique role in the pathophysiology of migraines renders it a unique target for therapeutic intervention. Early studies revealing clinical migraine benefit after MMA disruption underscore the potential therapeutic value of MMA embolization. MMA embolization has been demonstrated to be safe and feasible.
