Takahashi Kazuya, Muraoka Kenichiro, Sugiura Tomoyuki, Maeda Yasuhiko, Mandai Shinya, Gohda Yuji, Kawauchi Masamitsu, Matsumoto Yuzo
Department of Neurosurgery, Kagawa Prefectural Central Hospital, 5-4-16 Ban-cho, Takamatsu-city, Kagawa 760-0017, Japan.
No Shinkei Geka. 2002 May;30(5):535-9.
The authors present three cases of refractory chronic subdural hematoma (CSDH) treated by embolization of the middle meningeal artery (MMA) after several unsuccessful drainage procedures. The patients were initially treated by the usual method of burr hole and irrigation of the hematoma. After recurrence, several percutaneous puncture and drainage procedures were unable to prevent re-collection of the hematoma. Then the authors embolized the MMA which was thought to be the feeding artery of the outer membrane of the hematoma cavity. No enlargement of the hematoma was seen after embolization and, gradually, complete resolution of the hematoma was obtained. The outcome of the patients was excellent in all three cases. This new therapeutic approach to recurrent CSDH is discussed.
作者报告了3例难治性慢性硬膜下血肿（CSDH）病例，这些病例在多次引流手术失败后通过栓塞脑膜中动脉（MMA）进行治疗。患者最初采用常规的钻孔和血肿冲洗方法进行治疗。复发后，多次经皮穿刺引流手术均无法防止血肿再次形成。然后作者栓塞了被认为是血肿腔外膜供血动脉的MMA。栓塞后未见血肿增大，血肿逐渐完全消退。所有3例患者的预后均良好。本文讨论了这种复发性CSDH的新治疗方法。
