scholarly journals Anatomy of the Middle Meningeal Artery

2021 ◽  
Author(s):  
Marco Aurélio Ferrari Sant'Anna ◽  
Leonardo Luca Luciano ◽  
Pedro Henrique Silveira Chaves ◽  
Leticia Adrielle dos Santos ◽  
Rafaela Gonçalves Moreira ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Brain Lesion ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Brain Diseases ◽  
Surgical Removal ◽  
Maxillary Artery ◽  
Arteriovenous Fistulas ◽  
Moya Moya Disease ◽  
Meningeal Artery

Abstract Introduction The middle meningeal artery (MMA) is an important artery in neurosurgery. As the largest branch of the maxillary artery, it provides nutrition to the meninges and to the frontal and parietal regions. Diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (TAVF), Moya-Moya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine, and meningioma, may be related to the MMA. The aim of the present study is to describe the anatomy of the MMA and to correlate it with brain diseases. Methods A literature review was performed using the PubMed, Scielo, Scientific Direct, Ebsco, LILACS, TripDataBase and Cochrane databases, with the following descriptors: neurosurgery, neuroanatomy, meninges and blood supply. Discussion The MMA is embedded in a cranial groove, and traumatic or iatrogenic factors can result in MMA-associated pseudoaneurysms or arteriovenous fistulas (AVFs). In hemodynamic stress, true aneurysms can develop. Arteriovenous fistulas, pseudoaneurysms, and true aneurysms can be effectively treated by endovascular or surgical removal. In MMD, the MMA plays a role in the development and in the improvement of collateral circulation. Finally, in cases of CSDH, when standard surgery and drainage fail, MMA embolization can constitute a great alternative. Conclusion The MMA is a relevant structure for the understanding of neurosurgical diseases. In conclusion, every neurosurgeon must know the anatomy of the MMA sufficiently to correlate it with the diagnosed pathology, thus obtaining treatment effectiveness and preventing brain lesion.

scholarly journals Middle Meningeal Arteriovenous Fistula and its Spontaneous Closure

2007 ◽  
Vol 13 (2) ◽  
pp. 173-178 ◽  
Author(s):  
H.S. Chandrashekar ◽  
K. Nagarajan ◽  
S.G. Srikanth ◽  
P.N. Jayakumar ◽  
M.K. Vasudev ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Middle Meningeal Artery ◽  
Spontaneous Closure ◽  
Arteriovenous Fistulas ◽  
Post Traumatic ◽  
Meningeal Artery

Middle meningeal artery pseudo-aneurysms and arteriovenous fistulas are usually post-traumatic, although occasional iatrogenic cases have been reported. The treatment has been obliteration of the fistula by surgical or endovascular means. Spontaneous closure of fistula is uncommon. We report a case of non-traumatic middle meningeal arteriovenous fistula in a patient with alcoholism, which resolved spontaneously without treatment.

scholarly journals Incidentally discovered dural arteriovenous fistula during middle meningeal artery embolization for the treatment of chronic subdural hematoma

2021 ◽  
Vol 12 ◽  
pp. 438
Author(s):  
Borna Ethan Tabibian ◽  
Elizabeth Liptrap ◽  
Jesse Jones
Keyword(s):  
Arteriovenous Fistula ◽  
Subdural Hematoma ◽  
Dural Arteriovenous Fistula ◽  
Closed Head Injury ◽  
Treatment Strategies ◽  
Chronic Subdural Hematoma ◽  
Rare Condition ◽  
Middle Meningeal Artery ◽  
Presentation Methods ◽  
Meningeal Artery

Background: The incidence of chronic subdural hematoma (CSDH) is increasing with population age and anticoagulant use. Embolization of the middle meningeal artery (MMA) is an emerging, less invasive alternative to open surgery in treating this condition. Dural arteriovenous fistula (DAVF) is a rare condition whose association with CSDH is not well understood. We present three cases with incidentally discovered DAVFs during MMA embolization for the treatment of CSDH that necessitated adjustments to initial treatment strategy. Case Descriptions: We retrospectively reviewed all MMA embolizations performed for the treatment of CSDH beginning in 9/2019 to 11/2020. Imaging and hospital course of three cases of incidentally discovered DAVF, including patient demographics, clinical presentation, methods of treatment, imaging and outcome were assessed. Thirty MMA embolizations were performed as primary or adjunct treatment of CSDH. DAVF was discovered angiographically in 3 (10%) cases. All patients reported a history of prior closed head injury, although the timing of injury and subdural blood product age did not correlate in 2 of the 3 cases. All subjects experienced complete symptomatic and radiographic resolution of the subdural hematoma and DAVF following intervention. Conclusion: As MMA embolization for CSDH becomes more frequent, so may the incidental diagnosis of DAVF. Awareness of this potential association is critical to diagnosing DAVF with angiography and altering treatment strategies as needed.

scholarly journals Middle Meningeal Artery Embolization for the Treatment of Bilateral Chronic Subdural Hematoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Qi Wei ◽  
Gangxian Fan ◽  
Zhenzhu Li ◽  
Qingbo Wang ◽  
Ke Li ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Clinical Information ◽  
Middle Meningeal Artery ◽  
Burr Hole ◽  
Brain Diseases ◽  
Imaging Results ◽  
Retreatment Rate ◽  
Bilateral Chronic Subdural Hematoma ◽  
Meningeal Artery

Background: Bilateral chronic subdural hematoma (bCSDH) is a frequent condition commonly linked to the need for retreatment; however, the reason for this high retreatment rate remains unclear. The middle meningeal artery (MMA) was found to have a relationship with the occurrence and development of chronic subdural hematomas. This study examines a possible method to reduce bCSDH recurrence using bilateral MMA embolization combined with bilateral burr-hole drainage.Materials and Methods: Ten patients with bCSDH who underwent bilateral MMA embolization combined with bilateral burr-hole drainage at our hospital between June 2018 and May 2020, were retrospectively analyzed. Patients' clinical information, prognoses, imaging results, as well as surgical results were documented and analyzed.Results: Ten patients were diagnosed with bCSDH with no comorbid brain diseases. They underwent bilateral MMA embolization combined with bilateral burr-hole drainage. We embolized the MMA immediately before burr hole drainage successfully and employed angiography to validate these results. All the patients attained relief of symptoms without adverse events, and no re-expansion or relapse was reported in the follow-up computed tomography.Conclusion: Bilateral MMA embolization combined with bilateral burr-hole drainage is an available treatment for patients with bCSDH and may have the potential for preventing recurrence.

scholarly journals Proximity of the middle meningeal artery and maxillary artery to the mandibular head and mandibular neck as revealed by three-dimensional time-of-flight magnetic resonance angiography

2021 ◽  
Author(s):  
Daphne Schönegg ◽  
Raphael Ferrari ◽  
Julian Ebner ◽  
Michael Blumer ◽  
Martin Lanzer ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Three Dimensional ◽  
Time Of Flight ◽  
Middle Meningeal Artery ◽  
Individual Variability ◽  
Maxillary Artery ◽  
Condylar Process ◽  
The Mean ◽  
Meningeal Artery

Abstract Purpose The close topographic relationship between vascular and osseous structures in the condylar and subcondylar region and marked variability in the arterial course has been revealed by both imaging and cadaveric studies. This study aimed to verify the previously published information in a large sample and to determine a safe surgical region. Methods We analyzed the three-dimensional time-of-flight magnetic resonance angiography images of 300 individuals. Results The mean distance between the middle meningeal artery and the apex of the condyle or the most medial point of the condyle was 18.8 mm (range: 11.2–25.9 mm) or 14.5 mm (range: 8.8–22.9 mm) respectively. The course of the maxillary artery relative to the lateral pterygoid muscle was medial in 45.7% of cases and lateral in 54.3%. An asymmetric course was evident in 66 patients (22%). The mean distance between the maxillary artery and condylar process at the deepest point of the mandibular notch was 6.2 mm in sides exhibiting a medial course (range: 3.7–9.8 mm) and 6.6 mm in sides exhibiting a lateral course (range: 3.9–10.4 mm). The distances were significantly influenced by age, gender, and the course of the maxillary artery. Conclusion Our study emphasizes the marked inter- and intra-individual variability of the maxillary and middle meningeal arterial courses. We confirmed the proximity of the arteries to the condylar process. Extensive surgical experience and thorough preparation for each individual case are essential to prevent iatrogenic vascular injury.

scholarly journals Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 257
Author(s):  
Ambooj Tiwari ◽  
Adam A. Dmytriw ◽  
Ryan Bo ◽  
Nathan Farkas ◽  
Phillip Ye ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Volumetric Analysis ◽  
Primary Therapy ◽  
Curative Therapy ◽  
Complete Obliteration ◽  
Embolization Treatment ◽  
Long Term Follow Up ◽  
Meningeal Artery

Objective: To study the efficacy of middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematoma (SDH) and characterize its post-embolization volumetric resolution. Methods: Ten patients diagnosed with 13 cSDH underwent MMA embolization. SDH volumes were measured from time of initial discovery on imaging to pre-operative, post-operative, short-term and long-term follow-up. Time between procedure to obliteration was also measured. Volumetric analysis was done using the coniglobus formula, and recurrence rate as well as resolution timeline was defined using best-fit models. Results: Out of 10 patients, five were recurrent lesions, three were bilateral and seven unilateral cSDH. Average and median pre-operative volumes were 105.3 cc and 97.4 cc, respectively. Embolization on average was performed 21 days after discovery. Sixty percent of patients had concurrent antiplatelets or anticoagulation use. Forty percent underwent embolization treatment as the primary therapy. Recurrence was not seen in any patients treated with embolization. There were no peri- or post-operative complications. Five patients experienced complete or near-complete obliteration, while those with partial resolution showed a composite average of 75% volumetric reduction in 45 days. Post-embolization, the volumetric resolution followed an exponential decay curve over time and was independent of initial volume. Conclusion: MMA embolization contributed to a marked reduction in SDH volume post-operatively and can be used as a curative therapy for primary or recurrent chronic SDH.

scholarly journals Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

Radiology ◽  
2018 ◽  
Vol 286 (3) ◽  
pp. 992-999 ◽  
Author(s):  
Seung Pil Ban ◽  
Gyojun Hwang ◽  
Hyoung Soo Byoun ◽  
Tackeun Kim ◽  
Si Un Lee ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Artery Embolization ◽  
Meningeal Artery

Middle meningeal artery embolization for refractory chronic subdural hematoma

2000 ◽  
Vol 93 (4) ◽  
pp. 686-688 ◽  
Author(s):  
Shinya Mandai ◽  
Masaru Sakurai ◽  
Yuzo Matsumoto
Keyword(s):  
Liver Cirrhosis ◽  
Subdural Hematoma ◽  
Therapeutic Approach ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Artery Embolization ◽  
Content Type ◽  
Meningeal Artery ◽  
Fine Print

✓ The authors present a case of refractory chronic subdural hematoma (CSH) in a 59-year-old man with coagulopathy due to liver cirrhosis. The patient was successfully treated by embolization of the middle meningeal artery after several drainage procedures. This new therapeutic approach to recurrent CSH is discussed.

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