Blindness after middle meningeal artery embolization for skull metastasis of follicular thyroid carcinoma with ophthalmic artery variant

Skull metastasis of FTC is an uncommon clinical entity. This case highlights a serious complication of preoperative embolization due to a vascular variant in which the OphA was absent from the ICA and the central retinal artery originated from the MMA, leading to irreversible blindness. Thorough angiographic evaluation is essential to identify anatomical variants before embolization. When high-risk anatomy is present, alternative strategies should be considered to minimize the risk of ischemic complications.