Middle meningeal artery embolization contraindication when it originates from the ophthalmic artery

It aims to highlight the importance of anatomical variations of the (MMA) middle meningeal artery's origin in practice for neurointerventionalist. Before proceeding with embolization of the MMA in some pathologies, a critical analysis of the anatomy of these vessels should be done. When MMA originates from the ophthalmic artery, it is a formal contraindication to proceed with the embolization.[ 1 ] [ 2 ] Otherwise, major complications is embolization of the central retinal artery results in blindness.[ 3 ] A patient with recurrent chronic subdural hematoma and thrombocytopenia was referred to embolization of the MMA. Angiogram shows MMA originates in the OA, and the procedure was inadvisable ([ Figures 1 ] and [ 2 ]). Figure 1 Lateral view of a cerebral angiogram showing a right subdural hematoma and the right middle meningeal artery originates from the ophthalmic artery. Figure 2 Anteroposterior view of a cerebral angiogram showing a right subdural hematoma and the right middle meningeal artery originates from the ophthalmic artery. Authors' Contributions LPM: conceptualization, supervision, validation, visualization, writing – original draft, writing – review & editing; MGFA: data curation, writing – original draft; PLNG: writing – original draft, writing – review & editing; MASMJ: conceptualization, writing – original draft, writing – review & editing; JLJS: conceptualization, supervision, writing – review & editing. Publication History Received: 27 January 2024 Accepted: 22 February 2024 Article published online: 19 April 2024 © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Bibliographical Record Lívio Pereira de Macêdo, Mayle Gomes Ferreira de Araújo, Pedro Lucas Negromonte Guerra, Marcos Alcino Soares Siqueira Marques, José Laércio Júnior Silva. Middle meningeal artery embolization contraindication when it originates from the ophthalmic artery. Arq Neuropsiquiatr 2024; 82: s00441786023. DOI: 10.1055/s-0044-1786023