A case of recurrent subdural hematoma after unilateral MMA embolization that resolved after contralateral MMA embolization.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Interventional Neuroradiology Pub Date : 2024-12-11 DOI:10.1177/15910199241267342

Yigit Can Senol, Mona Asghariahmadabad, Daniel L Cooke, Luis E Savastano

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Abstract

Middle meningeal artery embolization (MMAe) is rapidly emerging as a valuable intervention to decrease the risk of recurrent subdural hematoma (SDH) after surgical evacuation. The role of upfront bilateral MMAe for unilateral SDH and the value of contralateral MMAe after SDH recurrence post evacuation and ipsilateral MMAe are still unknown. Here, we report the case of an elderly patient that presented with a large acute on chronic SDH and underwent surgical drainage and ipsilateral MMAe (with Contour PVA particles, 150-250 µm). At one month follow-up, he was found to have a significant radiographic recurrence of the SDH with interval acute hemorrhage. Angiography revealed complete occlusion of the trunk of the previously embolized ipsilateral MMA, and the presence of robust anastomotic branches from the contralateral MMA crossing the midline to collateralize patent distal branches of the previously embolized MMA. Decision was made to proceed with contralateral MMAe, which resulted in near complete SDH resolution at 6 months follow-up.

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单侧MMA栓塞后复发性硬膜下血肿1例，对侧MMA栓塞后消退。

脑膜中动脉栓塞术（MMAe）正迅速成为降低手术后硬膜下血肿（SDH）复发风险的一种有价值的干预措施。前侧双侧MMAe在单侧SDH中的作用以及对侧MMAe在SDH清除后复发和同侧MMAe后的价值尚不清楚。在这里，我们报告了一例老年患者，他出现了严重的急慢性SDH，并接受了手术引流和同侧MMAe（使用Contour PVA颗粒，150-250µm）。在一个月的随访中，他被发现有明显的SDH放射学复发伴间期急性出血。血管造影显示先前栓塞的同侧MMA的主干完全闭塞，并且存在来自对侧MMA的健壮的吻合分支穿过中线，以侧支连接先前栓塞的MMA的远端分支。我们决定继续进行对侧MMAe，在6个月的随访中，SDH几乎完全解决。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

3.60

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...