Middle meningeal artery embolization for chronic subdural hematoma in elderly patients at high risk of surgical treatment
10.7461/jcen.2022.E2022.08.003
- Author:
Jin Hoo SEOK
1
;
Jong Hyun KIM
;
Taek Hyun KWON
;
Joonho BYUN
;
Won Ki YOON
Author Information
1. Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea
- Publication Type:Clinical Article
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2023;25(1):28-35
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:The purpose of this study was to evaluate the effectiveness of middle meningeal artery embolization (MMAE) in elderly high-risk patients with symptomatic chronic subdural hematoma (CSDH) in terms of reduction in hematoma volume and recurrence rate.
Methods:We retrospectively reviewed data prospectively collected from nine patients who underwent 13 MMAE for CSDH between June 2017 and May 2022. The volume of the subdural hematoma was measured using a computer-aided volumetric analysis program. Hematoma volume changes during the follow-up period were analyzed and clinical outcomes were evaluated.
Results:The mean follow-up period was 160 days (range, 46−311 days). All procedures were technically successful and there were no procedure-related complications. Of the 13 MMAE, 84% (11 out of 13 hemispheres) showed mean 88% of reduction on follow-up volumetric study with eight cases of complete resolution. There was one refractory case with MMAE which had been performed multiple burr-hole trephinations, for which treatment was completed by craniotomy and meticulous resection of multiple pseudomembranes. There was no recurrent case during the follow-up period, except for refractory case.
Conclusions:MMAE for CSDH in selected high-risk elderly patients and relapsed patients might be effective. Despite the small cohort, our findings showed a high rate of complete resolution with no complications. Further prospective randomized trials are warranted to evaluate its usefulness as a primary treatment option for CSDH.
