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无水乙醇在经脑膜中动脉介入栓塞治疗外伤性颅内出血中的应用

Application of Absolute Alcohol in the Treatment of Traumatic Intracranial Hemorrhage via Interventional Embolization of Middle Meningeal Artery.

作者信息

Fan Gangxian, Wang Henglu, Ding Jinke, Xu Chao, Liu Yongliang, Wang Chao, Li Zefu

机构信息

Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China.

出版信息

Front Neurol. 2020 Aug 6;11:824. doi: 10.3389/fneur.2020.00824. eCollection 2020.

Abstract

Traumatic brain injury is a common condition in neurosurgery. Traditional methods of treatment include conservative treatment and surgical evacuation using burr-holes or craniotomy; however, studies have reported problems such as high re-expansion rates after conservative treatment of epidural hematoma and high postoperative recurrence rates of subdural hematoma. Solutions to these problems are lacking, and research into new treatment methods is ongoing. Among the potential new treatments, middle meningeal arterial embolization is an option. This study involved patients with acute epidural hematoma and chronic subdural hematoma. The purpose was to evaluate the use and effects of absolute alcohol to embolize the middle meningeal artery to treat intracranial hematoma. A retrospective description study was 12 cases of intracranial hematoma who treated with absolute alcohol interventional therapy from our hospital between June 2018 and October 2019. Five patients with acute epidural hematoma and seven patients with chronic subdural hematoma were treated using absolute alcohol to embolize the middle meningeal artery. Patients' clinical data, imaging results, surgical results, and prognosis were recorded and analyzed. All patients underwent absolute alcohol embolization of the middle meningeal artery, in combination with burr-hole drainage. All imaging data were confirmed preoperatively. We successfully used absolute alcohol to embolize the middle meningeal artery intraoperatively and confirmed these results by postoperative angiography. All patients achieved symptomatic relief without complications, and no recurrence or re-expansion was seen with follow-up computed tomography. Our study has been registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn, ChiCTR1800018714). The use of absolute alcohol to embolize the middle meningeal artery could be used as an attempt to treat acute epidural hematoma and chronic subdural hematoma.

摘要

创伤性脑损伤是神经外科的常见病症。传统治疗方法包括保守治疗以及使用钻孔或开颅手术进行手术引流;然而,研究报告称,硬膜外血肿保守治疗后再扩张率高以及硬膜下血肿术后复发率高等问题。这些问题缺乏解决方案,新治疗方法的研究正在进行中。在潜在的新治疗方法中,脑膜中动脉栓塞是一种选择。本研究纳入了急性硬膜外血肿和慢性硬膜下血肿患者。目的是评估使用无水乙醇栓塞脑膜中动脉治疗颅内血肿的应用及效果。这是一项回顾性描述性研究,研究对象为2018年6月至2019年10月在我院接受无水乙醇介入治疗的12例颅内血肿患者。其中5例急性硬膜外血肿患者和7例慢性硬膜下血肿患者接受了无水乙醇栓塞脑膜中动脉治疗。记录并分析患者的临床资料、影像学结果、手术结果及预后情况。所有患者均接受了脑膜中动脉无水乙醇栓塞,并结合钻孔引流。所有影像学资料均在术前得到确认。我们在术中成功使用无水乙醇栓塞脑膜中动脉,并通过术后血管造影证实了这些结果。所有患者症状均得到缓解,无并发症发生,随访计算机断层扫描未见复发或再扩张。本研究已在中国临床试验注册中心注册(http://www.chictr.org.cn,ChiCTR1800018714)。使用无水乙醇栓塞脑膜中动脉可作为治疗急性硬膜外血肿和慢性硬膜下血肿的一种尝试。

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