Diplopia after middle meningeal artery embolization for chronic subdural hematoma: A case report

Figure 1 Computed tomography and angiography. A: Brain computed tomography scan shows left chronic subdural hematoma; B: Middle meningeal artery (MMA) angiography revealed absence of detectable anastomotic artery along the anterior trunk; C: The tip of the microcatheter (white arrow) was placed distal to the main trunk of the anterior branch of the MMA for polyvinyl alcohol (PVA) injection; D: Lateral imaging of the microcatheter tip (white arrow) retracted due to intraoperative patient movement, revealing the anastomotic artery (black arrow) upon PVA injection; E: Anteroposterior view of PVA flowing through the long, tortuous sphenoidal artery (black arrow) to the lacrimal artery, which supplies the outer superior quadrant of the orbit; F: Reflux of PVA into the anastomotic artery (black arrow) during reinjection; G: Post-embolization contrast showing complete occlusion of the anterior and posterior branches of the MMA, with coils visible in the anterior branch (black arrow).