Which surgical procedure is effective for refractory chronic subdural hematoma? Analysis of our surgical procedures and literature review

Embolization of Middle Meningeal Artery for the Treatment of Headaches Induced by Chronic Subdural Hematoma: A Case Report

“…Trephination is the first recorded treatment for headaches, performed in order to free evil spirits from a patient’s head . While burr‐hole irrigation or craniotomy for hematoma evacuation remains the primary treatment option for CSDH, recurrence rates remain high . The morbidity and risks associated with surgery often make this a poor option for those with benign symptoms such as mild headaches.…”

“…The morbidity and risks associated with surgery often make this a poor option for those with benign symptoms such as mild headaches. Endovascular management of CSDH via embolization of the MMA has yielded promising results . However, most reports in the current literature discuss patients who underwent MMA embolization in combination with surgical evacuation, often after recurrence of the hematoma after initial surgical evacuation.…”

“…Although surgical evacuation remains the most common surgical option, this approach often requires prolonged time off of blood thinning medication . There are only a few contraindications to endovascular embolization of the MMA, and if no anastomosis exists between external carotid artery ethmoidal branches and the ophthalmic artery it can be performed with minimal risk, under conscious sedation .…”

“…2 While burr-hole irrigation or craniotomy for hematoma evacuation remains the primary treatment option for CSDH, recurrence rates remain high. 3,4 The morbidity and risks associated with surgery often make this a poor option for those with benign symptoms such as mild headaches. Endovascular management of CSDH via embolization of the MMA has yielded promising results.…”

“…Endovascular management of CSDH via embolization of the MMA has yielded promising results. 3 However, most reports in the current literature discuss patients who underwent MMA embolization in combination with surgical evacuation, often after recurrence of the hematoma after initial surgical evacuation. We present a patient with persistent headaches secondary to CSDH managed by MMA embolization alone.…”