Middle Meningeal artery Embolization of Septated Chronic Subdural Hematomas

Authors

Juan Carlos Martinez-Gutierrez
Salvatore A D'Amato
Hussein A Zeineddine
Michael I Nahhas
Matthew J Kole
Hyun Woo Kim
Youngran Kim
Bryden H Dawes
Peng Roc Chen
Spiros L Blackburn
Sunil A Sheth
Gary Spiegel
Ching-Jen Chen
Ashutosh Mahapatra
Ryan S Kitagawa
Mark J Dannenbaum

Publication Date

6-26-2023

Journal

Interventional Neuroradiology

Abstract

INTRODUCTION: Middle meningeal artery embolization (MMAE) has emerged as a promising new treatment for patients with chronic subdural hematomas (cSDH). Its efficacy, however, upon the subtype with a high rate of recurrence-septated cSDH-remains undetermined.

METHODS: From our prospective registry of patients with cSDH treated with MMAE, we classified patients based on the presence or absence of septations. The primary outcome was the rate of recurrence of cSDH. Secondary outcomes included a reduction in cSDH thickness, midline shift, and rate of reoperation.

RESULTS: Among 80 patients with 99 cSDHs, the median age was 68 years (IQR 59-77) with 20% females. Twenty-eight cSDHs (35%) had septations identified on imaging. Surgical evacuation with burr holes was performed in 45% and craniotomy in 18.8%. Baseline characteristics between no-septations (no-SEP) and septations (SEP) groups were similar except for median age (SEP vs no-SEP, 72.5 vs. 65.5, p

CONCLUSION: MMAE appears to be equal to potentially more effective in preventing the recurrence of cSDH in septated lesions. These findings may aid in patient selection.

Keywords

Subdural hemorrhage, embolization, endovascular therapy