Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: Theory, current practice and future directions

Marco Mancuso-Marcello; Adnan I Qureshi; Christos Nikola; Irina Stoian; YiFan Jia; Danial Saeed; Pervinder Bhogal

doi:10.1177/15910199231195470

Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: Theory, current practice and future directions

Interv Neuroradiol. 2026 Feb;32(1):104-108. doi: 10.1177/15910199231195470. Epub 2023 Aug 13.

Authors

Marco Mancuso-Marcello¹, Adnan I Qureshi², Christos Nikola³, Irina Stoian³, YiFan Jia⁴, Danial Saeed³, Pervinder Bhogal¹

Affiliations

¹ Interventional Neuroradiology, Barts Health NHS Trust, London, UK.
² Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, USA.
³ Stroke, Barts Health NHS Trust, London, UK.
⁴ Imperial College School of Medicine, Imperial College London, London, UK.

Abstract

Recent developments in neurointerventional research have seen the emergence of the middle meningeal artery (MMA) as an effective conduit for intra-arterial (IA) therapy for a number of pathologies. Here, we review the anatomical, pathophysiological and experimental basis for utilisation of the MMA for IA treatment of migraine headache. We explore the in-human case literature for the treatment of headaches with IA lidocaine and discuss considerations and challenges for future research.

Keywords: Migraine disorders; headache; injections; intra-arterial.

Publication types

Review

MeSH terms

Anesthetics, Local* / administration & dosage
Anesthetics, Local* / therapeutic use
Humans
Injections, Intra-Arterial
Lidocaine* / administration & dosage
Lidocaine* / therapeutic use
Meningeal Arteries* / anatomy & histology
Migraine Disorders* / drug therapy

Substances

Lidocaine
Anesthetics, Local