Recurrent Acute Subdural Hematoma Due to Middle Meningeal Artery Bleeding Treated by Embolization

Ding, Huaqiang; Quan, Xingyun; Liao, Shuai; Liu, Shengjie; Liu, Liang

doi:10.1016/j.wneu.2019.10.028

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…Ding et al successfully performed MMA embolization on a 56-year-old woman with a right hemispheric aSDH 2 days after undergoing a craniotomy for evacuation. The patient did not develop recurrent hemorrhage upon follow-up ( 12 ). This was the only study to our knowledge to have explored MMA embolization as a treatment for aSDH in our literature search.…”

Section: Discussionmentioning

confidence: 90%

“…In recent years, embolization of the middle meningeal artery (MMA) has been recognized as an alternative or adjuvant treatment to surgical evacuation for recurrent and primary chronic subdural hematoma (cSDH) ( 8 – 12 ). Notably, peripheral branches of the MMA directly provide the blood supply for fragile sinusoidal neovessels that compose the outer neomembrane of cSDH ( 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, patients who were treated with MMA embolization were found to have complete hematoma resolution ( 11 ). Details regarding the technique of MMA embolization are limited; however, injection of polyvinyl alcohol particles was utilized in our technique and reported by other studies as well ( 8 , 10 , 12 ). Notably, Aronov et al employed the non-adhesive SQUID-18 embolic agent as a treatment for recurrent cSDH warranting further research to determine the most effective agent ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

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Cerebral venous sinus thrombosis with an acute subdural hematoma treated with endovascular intervention: A case report

Crouch

Quig²,

Yap³

et al. 2022

Front. Neurol.

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We report two cases of endovascular intervention for management of cerebral venous sinus thrombosis complicated by an acute intracranial hemorrhage during treatment with therapeutic anticoagulation. The first patient developed an acute subdural hematoma with progressive enlargement and was subsequently managed with venous sinus thrombectomy. The second patient developed an intraparenchymal and subdural hematoma and was treated with middle meningeal embolization. Anticoagulation is the primary treatment for cerebral venous sinus thrombosis but also contraindicated in an acute intracranial hemorrhage. In these cases, after endovascular intervention both patients resumed therapeutic anticoagulation without further hematoma expansion or additional invasive interventions. Both patients made an excellent neurological recovery and returned to their baseline functional independent status. Given the need for anticoagulation, endovascular intervention in the form of thrombectomy or middle meningeal artery embolization may be a viable adjuvant to anticoagulation in select patients.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cerebral venous sinus thrombosis with an acute subdural hematoma treated with endovascular intervention: A case report

Crouch

Quig²,

Yap³

et al. 2022

Front. Neurol.

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Combined CSF-venous Fistula and middle meningeal artery embolization for treatment of spontaneous intracranial hypotension

et al. 2022

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Transvenous Onyx embolization was recently described as an effective treatment of spontaneous intracranial hypotension caused by CSF-venous fistulas. Patients with CSF-venous fistulas can present with a wide spectrum of clinical and imaging findings, sometimes including spontaneous subdural hematomas, subdural hygromas, or a combination of both. Here, we describe four patients with spontaneous intracranial hypotension complicated by subdural fluid collections caused by CSF-venous fistulas. The patients were treated with transvenous Onyx embolization of their CSF-venous fistulas and transarterial particle embolization of the bilateral middle meningeal arteries, with both procedures performed in a single treatment session. All four patients had clinical improvement and decreased size or resolution of their subdural fluid collections. Based on our findings, we believe that middle meningeal embolization could be a useful adjunct to CSF-venous fistula embolization. A case-control study comparing patients who did or did not undergo middle meningeal embolization will be necessary to validate this supposition.

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Recurrent Acute Subdural Hematoma Due to Middle Meningeal Artery Bleeding Treated by Embolization

Cited by 2 publications

References 11 publications

Cerebral venous sinus thrombosis with an acute subdural hematoma treated with endovascular intervention: A case report

Cerebral venous sinus thrombosis with an acute subdural hematoma treated with endovascular intervention: A case report

Combined CSF-venous Fistula and middle meningeal artery embolization for treatment of spontaneous intracranial hypotension

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