Usefulness of interventional embolization of the middle meningeal artery for recurrent chronic subdural hematoma: Five cases and a review of the literature

Tempaku, Akira; Yamauchi, Shigeru; Ikeda, Hidetoshi; Tsubota, Nobuyuki; Furukawa, Hironori; Maeda, Daisuke; Kondo, Kimito; Nishio, Akimasa

doi:10.1177/1591019915583224

Cited by 103 publications

(85 citation statements)

References 37 publications

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“…This was followed by a number of studies that demonstrated the efficacy of the treatment. 10–14) The rational for this treatment was based on the findings by Tanaka et al that many small branches of the dural artery on connected to the fragile microcapillaries in the outer membrane of the chronic SDH capsule. 15–18) Repetitive bleeding and chronic inflammation are considered the cause of the SDH expansion.…”

Section: Discussionmentioning

confidence: 99%

Embolization for Refractory Subacute Subdural Hematoma in a Child with Severe Hemophilia Type A

Higaki

Namba²,

Watanabe

et al. 2017

NMC Case Report Journal

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Hemophilia is an X-linked hemorrhagic disease due to coagulation factor VIII or IX deficiency with approximately 5–10% incidence of central nervous system bleeding. We present an intriguing case of a refractory subacute subdural hematoma (SDH) controlled with endovascular embolization in a hemophilic patient. A 5-year-old severe hemophilic A boy presented with a life threatening left parietal subcortical hemorrhage, for which he underwent craniotomy and evacuation of the hematoma. Recurrent hemorrhage necessitated a repeat craniotomy. This was followed by three episodes of SDH development at the craniotomy site that were treated surgically, and finally controlled with embolization in the subacute period. This case presents a novel option for treating a refractory SDH in patients with coagulation disorders.

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Section: Discussionmentioning

confidence: 99%

Embolization for Refractory Subacute Subdural Hematoma in a Child with Severe Hemophilia Type A

Higaki

Namba²,

Watanabe

et al. 2017

NMC Case Report Journal

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“…In patients with an intracranial hematoma and cranial or facial fractures or with recurrent subdural hematoma who had a severe coagulopathy on anticoagulants, we secured endovascular hemostasis with a middle meningeal artery embolization after a consultation with the neurosurgeons before any conservative or surgical treatment. 5,6 When an angiography showed CM extravasations or pseudoaneurysms from arterial injuries caused by solid organ injuries, pelvic fractures, or other injuries, the trained acute care specialists performed a therapeutic AVIRT.…”

Section: Methodsmentioning

confidence: 99%

Availability of on-site acute vascular interventional radiology techniques performed by trained acute care specialists

Tsurukiri¹,

Ohta

Mishima³

et al. 2017

Journal of Trauma and Acute Care Surgery

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INTRODUCTIONComprehensive treatment of a patient in acute medicine and surgery requires the use of both surgical techniques and other treatment methods. Recently, acute vascular interventional radiology techniques (AVIRTs) have become increasingly popular, enabling adequately trained in-house experts to improve the quality of on-site care.METHODSAfter obtaining approval from our institutional ethics committee, we conducted a retrospective study of AVIRT procedures performed by acute care specialists trained in acute medicine and surgery over a 1-year period, including those conducted out of hours. Trained acute care specialists were required to be certified by the Japanese Association of Acute Medicine and to have completed at least 1 year of training as a member of the endovascular team in the radiology department of another university hospital. The study was designed to ensure that at least one of the physicians was available to perform AVIRT within 1 h of a request at any time. Femoral sheath insertion was usually performed by the resident physicians under the guidance of trained acute care specialists.RESULTSThe study sample comprised 77 endovascular procedures for therapeutic AVIRT (trauma, n = 29, and nontrauma, n = 48) among 62 patients (mean age, 64 years; range, 9–88 years), of which 55% were male. Of the procedures, 47% were performed out of hours (trauma, 52%; and nontrauma, 44%). Three patients underwent resuscitative endovascular balloon occlusion of the aorta in the emergency room. No major device-related complications were encountered, and the overall mortality rate within 60 days was 8%. The recorded causes of death included exsanguination (n = 2), pneumonia (n = 2), sepsis (n = 1), and brain death (n = 1).CONCLUSIONWhen performed by trained acute care specialists, AVIRT seems to be advantageous for acute on-site care and provides good technical success. Therefore, a standard training program should be established for acute care specialists or trauma surgeons to make these techniques a part of the standard regimen.LEVEL OF EVIDENCETherapy/care management study, level V.

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“…It shows iatrogenic dAVF after burr hole placement treated successfully with embolization of ipsilateral MMA.Embolization of the MMA is highly useful for refractory CSDH as per literature review 1,5,6,9,10. Tempaku et al10 showed efficacy of embolization of MMA in five patients. Hashimoto et al 1 andMino et al 9 also support use of embolization of MMA in refractory CSDH.…”

mentioning

confidence: 95%

Usefulness of Embolization for Iatrogenic Dural Arteriovenous Fistula Associated with Recurrent Chronic Subdural Hematoma: A Case Report and Literature Review

et al. 2016

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Usefulness of interventional embolization of the middle meningeal artery for recurrent chronic subdural hematoma: Five cases and a review of the literature

Cited by 103 publications

References 37 publications

Embolization for Refractory Subacute Subdural Hematoma in a Child with Severe Hemophilia Type A

Embolization for Refractory Subacute Subdural Hematoma in a Child with Severe Hemophilia Type A

Availability of on-site acute vascular interventional radiology techniques performed by trained acute care specialists

Usefulness of Embolization for Iatrogenic Dural Arteriovenous Fistula Associated with Recurrent Chronic Subdural Hematoma: A Case Report and Literature Review

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