Middle meningeal artery embolization and pediatric chronic subdural hematoma: a systematic review of the literature

Siahaan, Andre Marolop Pangihutan; Indharty, Suzy; Tandean, Steven; Tommy, Thomas; Loe, Michael Lumintang; Nainggolan, Bahagia Willibrordus Maria; Pangestu, Dimas; Susanto, Martin

doi:10.1007/s10143-023-02130-0

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…28 Pediatric patients have a lesser incidence of cSDH given its etiology, however, studies demonstrate the efficacy of MMAE in this population as well. 29 Further research is required to validate these findings but MMAE appears to be a promising option.…”

Section: Middle Meningeal Artery Embolizationmentioning

confidence: 98%

Updates in traumatic brain injury management: brain oxygenation, middle meningeal artery embolization and new protocols

Egodage,

Patel

2024

Trauma Surg Acute Care Open

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Traumatic brain injury (TBI) confers significant morbidity and mortality, and is a pathology often encountered by trauma surgeons. Several recent trials have evaluated management protocols of patients with severe TBI. The Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II trial (BOOST-II) evaluated efficacy and feasibility of brain oxygen measurement in severe TBI. BOOST phase 3 trial (BOOST-3) and two ongoing trials look to measure functional outcomes in this population. Furthermore, middle meningeal artery embolization has now become standard therapy for adult patients with chronic subdural hematoma (SDH) and has increasing popularity in those with recurrent SDH as an alternative to surgical intervention. In this manuscript, we review the literature, ongoing trials, and discuss current updates in the management of TBI.

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Section: Middle Meningeal Artery Embolizationmentioning

confidence: 98%

Updates in traumatic brain injury management: brain oxygenation, middle meningeal artery embolization and new protocols

Egodage,

Patel

2024

Trauma Surg Acute Care Open

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Examining the standalone efficacy and safety of tranexamic acid in chronic subdural hematoma: a comprehensive review and meta-analysis

Ali,

Haseeb,

Shafique

et al. 2024

Egypt J Neurosurg

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Background Chronic subdural hematoma (CSDH) is an important medical condition characterized by the accumulation of blood in the subdural space. Several methods have been explored, including surgical intervention and administration of tranexamic acid, which is a conservative treatment option. This meta-analysis aimed to assess the effectiveness and safety of tranexamic acid in CSDH management. Methods A systematic literature search was performed according to the PRISMA and MOOSE guidelines. This study included cohort and randomized controlled trials involving adults with chronic subdural hematoma (CSDH) who were treated with intravenous tranexamic acid. The primary outcome measures were recurrence and adverse events. Results Six studies encompassing 2024 participants were included. Studies have shown that tranexamic acid reduced recurrence rates (OR, 0.32; 95% CI: 0.27–0.38, p = 0.16; I2 = 0%), although the result was non-significant. However, the analysis of adverse events indicated a moderate level of heterogeneity (OR, 1.14; 95% CI: 0.60–2.15, p = 0.07; I2 = 57%), suggesting a potential safety concern. Conclusion In conclusion, this meta-analysis suggests tranexamic acid (TXA) may reduce chronic subdural hematoma (CSDH) recurrence, though significance varied across studies. Adverse effects with TXA were similar to controls. Larger trials are needed to confirm TXA’s role in CSDH management.

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Relative Cortical Atrophy Index as a Strong Predictor of Recurrence After Surgery for Chronic Subdural Hematoma

Charehsaz,

Vayisoglu,

Uyaniker

et al. 2024

Neurosurgery

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BACKGROUND AND OBJECTIVES: Chronic subdural hematoma (CSDH) presents significant management challenges in neurosurgical practice, with recurrence being a notable postoperative consideration. This study aimed to evaluate the Relative Cortical Atrophy (RCA) Index as a predictor of recurrence after CSDH surgery. METHODS: A retrospective analysis was conducted on 98 patients who underwent surgical evacuation for unilateral CSDH. The RCA Index was calculated using pre- and postoperative cranial imaging, correlating it with patient demographics, hematoma characteristics, and recurrence. Inter-rater reliability among measurements by 4 independent physicians was assessed using the intraclass correlation coefficient (ICC). Correlation and regression analyses were performed to identify the correlation of the RCA Index with other factors and their potential predicting power of CSDH recurrence, respectively. RESULTS: The study population had a mean age of 74.1 (11.9) years, with a 23.5% (23 patients) recurrence rate of CSDH. The ICC analysis showed excellent inter-rater reliability for RCA Index measurements (ICC: 0.998, 95% CI: 0.997-0.998, P < .001). A higher preoperative RCA Index was significantly associated with recurrence (0.215 [0.031] in the recurrent group vs 0.125 [0.034] in the nonrecurrent group, P < .001). The preoperative RCA Index highly correlated with the postoperative RCA Index (Pearson's correlation: 0.918, P < .001), and there was only a small (average: 0.005) but significant increase in the RCA Index of the unaffected hemisphere after surgery (P = .01).The preoperative RCA Index positively correlated with age, preoperative SDH thickness and volume, and recurrence. A RCA Index cutoff value of 0.165 predicted CSDH recurrence with high sensitivity (95.6%) and specificity (93.3%) (area under the curve = 0.97, 95% CI: 0.93-1). CONCLUSION: The RCA Index is a simple yet robust predictor of CSDH recurrence. Incorporating this measure into the preoperative assessment may enhance surgical planning and postoperative management, potentially reducing recurrence rates.

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Middle meningeal artery embolization and pediatric chronic subdural hematoma: a systematic review of the literature

Cited by 4 publications

References 27 publications

Updates in traumatic brain injury management: brain oxygenation, middle meningeal artery embolization and new protocols

Updates in traumatic brain injury management: brain oxygenation, middle meningeal artery embolization and new protocols

Examining the standalone efficacy and safety of tranexamic acid in chronic subdural hematoma: a comprehensive review and meta-analysis

Relative Cortical Atrophy Index as a Strong Predictor of Recurrence After Surgery for Chronic Subdural Hematoma

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