Zhao F, Su CH, Hu SX, Feng L. Diplopia after middle meningeal artery embolization for chronic subdural hematoma: A case report. World J Clin Cases 2025; 13(23): 106329 [DOI: 10.12998/wjcc.v13.i23.106329]
Corresponding Author of This Article
Lei Feng, Chief, Department of Neurosurgery, Jining NO.1 People's Hospital Affiliated to Shandong First Medical University, Shandong Academy of Medical Sciences, No. 6 Jiankang Road, Rencheng District, Jining 272000, Shandong Province, China. flneuro@163.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2025; 13(23): 106329 Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.106329
Diplopia after middle meningeal artery embolization for chronic subdural hematoma: A case report
Feng Zhao, Chun-Hai Su, Shun-Xin Hu, Lei Feng
Feng Zhao, Chun-Hai Su, Shun-Xin Hu, Lei Feng, Department of Neurosurgery, Jining NO.1 People's Hospital Affiliated to Shandong First Medical University, Shandong Academy of Medical Sciences, Jining 272000, Shandong Province, China
Feng Zhao, Chun-Hai Su, Shun-Xin Hu, Lei Feng, Shandong Provincial Key Medical and Health Laboratory of Neuroinjury and Repair, Jining 272000, Shandong Province, China
Author contributions: Zhao F and Hu SX contributed to manuscript drafting; Feng L reviewed the literature; Su CH was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: The patient and his family provided their written informed consent and agreed to the publication of this case report.
Conflict-of-interest statement: All authors declare that there is no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Feng, Chief, Department of Neurosurgery, Jining NO.1 People's Hospital Affiliated to Shandong First Medical University, Shandong Academy of Medical Sciences, No. 6 Jiankang Road, Rencheng District, Jining 272000, Shandong Province, China. flneuro@163.com
Received: February 24, 2025 Revised: March 30, 2025 Accepted: April 25, 2025 Published online: August 16, 2025 Processing time: 102 Days and 4.7 Hours
Abstract
BACKGROUND
Middle meningeal artery embolization (MMAE) is emerging as a promising treatment for chronic subdural hematoma (CSDH), serving both as an adjunct to surgery and as a primary therapeutic option depending on patient presentation. Due to its low recurrence rate and minimal complications, MMAE has gained increasing acceptance among clinicians in recent years. This report presents a case of diplopia following MMAE due to the presence of a potential anastomotic artery, aiming to enhance awareness of this complication.
CASE SUMMARY
A 60-year-old male patient presented with a headache following head trauma, and cranial computed tomography revealed a left-sided CSDH. The patient underwent left MMAE; however, polyvinyl alcohol particles inadvertently flowed into the lacrimal artery through an anastomotic artery, resulting in diplopia due to impaired abduction of the left eye. The diplopia resolved by postoperative day 40. The patient’s headache resolved by postoperative day 7, and the hematoma completely resolved by postoperative day 108.
CONCLUSION
Potential anastomotic arteries in the middle meningeal artery (MMA) can lead to serious complications. Superselective angiography of the MMA or its branches prior to embolization is essential. Performing embolization distal to potential anastomotic sites can reduce risks, and the presence of an anastomosis may warrant coil embolization or termination of the procedure.
Core Tip: Middle meningeal artery embolization is emerging as a potential treatment for chronic subdural hematoma. However, the presence of anastomotic arteries in the middle meningeal artery can complicate the procedure, potentially leading to severe complications if not identified preoperatively.
