{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:33:57Z","timestamp":1793144037729,"version":"4.5.0"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Migraine is the most common neurological problem in primary care affecting 18% of women and 6% of men, while chronic migraine affects 2% of the population and refractory migraine is estimated to affect between 5% and 30% of migraine sufferers. The dura is a well-vascularized structure, which is densely innervated by pain fibers. Intra-arterial administration of lidocaine in the middle meningeal artery (MMA) has been used for refractory migraine, promoting pain relief. Patients with chronic headaches who underwent embolization of the MMA for the prevention of chronic subdural hematoma recurrence experienced complete resolution of pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on this data, we treated 10 patients consecutively with chronic and refractory migraine with a high degree of disability assessed by headache impact test (HIT-6) who experimented with pain relief with lidocaine injection and subsequently underwent definitive bilateral occlusion of the MMA with biological glue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age was 48.2\u2009\u00b1\u200914.4, with 90% being female, all patients confirmed primary headache in the lidocaine suppression test (LST) and after bilateral occlusion was observed worsening of pain between 0 h and 6 h (\u22120.9 (95% CI \u22122.2\u20130.6,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.193) with complete improvement at discharge within 24\u2005h. In the 30-day follow-up, we observed a significant improvement in HIT-6, 30.5 (95% CI 25.5\u201335.5,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) that lasted up to 6 months. No neurological or technical complications were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with chronic or refractory migraine, rigorously selected through the LST, may benefit from bilateral occlusion of the MMA for a period of up to 6 months, without additional risks. Despite the positive results, we must emphasize the preliminary nature of these findings, especially given the small sample size. A multicenter, randomized study is needed to prove the efficacy and safety of this new treatment and it may be an alternative for a specific subset of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251337520","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T03:37:41Z","timestamp":1748835461000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Chronic migraine and bilateral occlusion of the middle meningeal artery"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5100-5624","authenticated-orcid":false,"given":"Jos\u00e9 Ricardo","family":"Vanzin","sequence":"first","affiliation":[{"name":"Vascular Neurosurgeon and Interventional Neuroradiology of Neurology and Neurosurgery Service, Passo Fundo, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4291-3831","authenticated-orcid":false,"given":"Luciano Bambini","family":"Manzato","sequence":"additional","affiliation":[{"name":"Vascular Neurosurgeon and Interventional Neuroradiology of Neurology and Neurosurgery Service, Passo Fundo, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-020-01208-0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2008.01135.x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4522(88)90064-4"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.07-12-04129.1987"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1944.7.6.359"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/117.1.199"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1960.23.3.246"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1964.206.5.1177"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22329"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0511-10.2010"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm0202-136"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S329280"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22292"},{"key":"e_1_3_3_15_2","first-page":"2673","article-title":"Meningeal contribution to migraine pain: a magnetic resonance study","volume":"41","author":"Khan S","year":"2021","unstructured":"Khan S, Amin FM, Christensen CE, et al. Meningeal contribution to migraine pain: a magnetic resonance study. J Neurosci 2021; 41: 2673\u20132682.","journal-title":"J Neurosci"},{"key":"e_1_3_3_16_2","first-page":"69","article-title":"Effect of intra-arterial injection of lidocaine and methylprednisolone into the middle meningeal artery on intractable headaches","volume":"7","author":"Qureshi AI","year":"2014","unstructured":"Qureshi AI, Qureshi MH, Khan AA, et al. Effect of intra-arterial injection of lidocaine and methylprednisolone into the middle meningeal artery on intractable headaches. J Vasc Interv Neurol 2014; 7: 69\u201372.","journal-title":"J Vasc Interv Neurol"},{"key":"e_1_3_3_17_2","article-title":"Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: theory, current practice and future directions","author":"Mancuso-Marcello M","unstructured":"Mancuso-Marcello M, Qureshi AI, Nikola C, et al. Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: theory, current practice and future directions. Interv Neuroradiol. Epub ahead of print 13 August 2023. DOI: https:\/\/doi.org\/10.1177\/15910199231170695.","journal-title":"Interv Neuroradiol."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12476"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-017602"},{"key":"e_1_3_3_20_2","article-title":"Refractory migraine: a cerebrovascular disease?","author":"Fiorella D","unstructured":"Fiorella D, Arthur AS, Yuan H, et al. Refractory migraine: a cerebrovascular disease? J Neurointerv Surg 2023; 7: 637\u2013639.","journal-title":"J Neurointerv Surg"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-014-0117-0"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.14049"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4522(91)90253-K"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.1990.tb14679.x"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0014-2999(89)90719-X"},{"key":"e_1_3_3_26_2","first-page":"1317","article-title":"MR Imaging of the trigeminal ganglion, nerve, and the perineural vascular plexus: normal appearance and variants with correlation to cadaver specimens","volume":"24","author":"Williams LS","year":"2023","unstructured":"Williams LS, Schmalfuss IM, Sistrom CL, et al. MR Imaging of the trigeminal ganglion, nerve, and the perineural vascular plexus: normal appearance and variants with correlation to cadaver specimens. AJNR Am J Neuroradiol 2023; 24: 1317\u20131323. PMC7973681.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_3_27_2","article-title":"Middle meningeal artery embolization in migraine: from concept to reality","author":"Mortezaei A","unstructured":"Mortezaei A, Essibayi MA, Osama M, et al. Middle meningeal artery embolization in migraine: from concept to reality. Interv Neuroradiol 2024: 1\u20139. 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