Efficacy of middle meningeal artery embolization in the treatment of refractory chronic subdural hematoma.

Masaki Mino,Shinjitsu Nishimura,Mitsuomi Kaimori,Shingo Yonezawa,Hiroshi Midorikawa,Michiaharu Nishijima,Emiko Hori,Teruhiko Tanaka,Misaki Kohama

doi:10.4103/2152-7806.73801

Masaki Mino, Shinjitsu Nishimura + Show 7 more

Open Access

https://doi.org/10.4103/2152-7806.73801

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Abstract

Background:There are no established treatment procedures for repeatedly recurring chronic subdural hematoma (CSH). In this study, we discussed the efficacy of middle meningeal artery (MMA) embolization in preventing recurrence of CSH.Methods:We performed superselective angiography of MMA in four patients who suffered from repeated recurrence of CSH. After angiography, we performed embolization of MMA with endovascular procedure.Results:In all cases, superselective angiography of MMA revealed diffuse abnormal vascular stains that seemed to represent the macrocapillaries in the outer membrane of CSH. In all the patients, there were no recurrences or enlargements of CSH after the embolization of the MMA.Conclusion:MMA embolization can be an effective adjuvant procedure in preventing the recurrence of CSH.

Highlights

Single-burr-hole surgery has been established as an effective procedure for the treatment of chronic subdural hematoma (CSH).[3,11] in several patients, CSH recurs repeatedly, and there are no established treatment procedures for such cases
All the cases were initially treated with single-burr-hole surgery, but all the patients showed enlargement of CSH
In all the four cases, superselective angiography of middle meningeal artery (MMA) revealed diffuse abnormal vascular stains around the branches of MMA, which seemed to represent the macrocapillaries in the outer membrane of CSH [Figure 5]

Summary

Introduction

Single-burr-hole surgery (closed-system drainage or irrigation with or without drainage) has been established as an effective procedure for the treatment of chronic subdural hematoma (CSH).[3,11] in several patients, CSH recurs repeatedly, and there are no established treatment procedures for such cases. There are no established treatment procedures for repeatedly recurring chronic subdural hematoma (CSH). We discussed the efficacy of middle meningeal artery (MMA) embolization in preventing recurrence of CSH

Methods

Results

Discussion

Conclusion