P.158 Middle meningeal embolization for pediatric chronic subdural hematoma

Abstract

Background: Chronic subdural hematoma (CSDH), although common in the adult and geriatric populations, is a relatively rare condition in pediatric patients. Middle meningeal artery (MMA) embolization is a novel adjuvant endovascular procedure used to minimize the risk of recurrence of CSDH, and its use in pediatric populations is exceptionally rare. Methods: This is a case-report and review of the available literature. Results: A 14 year old male presented to the children hospital after an episode of dysarthria, word-finding aphasia and subtle right sided weakness. MRI revealed a CSDH left cerebral hemisphere with evidence of septations and an arachnoid cyst in the left middle cranial fossa. The patient underwent surgical drainage of the CSDH and subsequent MMA embolization. The patient made an excellent functional recovery with complete resolution of CSDH. Conclusions: Here we report our experience with MMA embolization as an adjuvant therapy for the treatment of a pediatric CSDH. We have found that MMA embolization provides a safe adjuvant therapy in the treatment of CSDH in the pediatric population, lending support to the limited literature of the utility of MMA in this age group. We propose that MMA embolization is safe and potentially efficatious in reducing risk of recurrence in pediatric complex, multi-loculated CSDHs