Otsuji Ryosuke, Amano Toshiyuki, Matsuo Satoshi, Miyamatsu Yuichiro, Hara Kenta, Tokunaga So, Nakamizo Akira
Department of Neurosurgery, National Hospital Organization Kyushu Medical Center, Clinical Research Institute, Fukuoka, Fukuoka, Japan.
Department of Neuroendovascular Surgery, National Hospital Organization Kyushu Medical Center, Clinical Research Institute, Fukuoka, Fukuoka, Japan.
NMC Case Rep J. 2022 Jun 15;9:151-155. doi: 10.2176/jns-nmc.2022-0007. eCollection 2022.
Endovascular embolization of the middle meningeal artery (MMA) has been reported as an effective method for treating chronic subdural hematoma (CSDH); however, its preventive effect on CSDH following craniotomy is unknown. We present a case in which MMA embolization was ineffective in preventing CSDH following craniotomy. A 56-year-old man who complained of diplopia was diagnosed with sphenoid ridge meningioma with a 3-cm diameter. MMA embolization prior to the operation and total surgical removal of the tumor were performed. Two months postoperatively, the patient complained of headache and hemiparesis of the left side. CSDH with a 15-mm thickness and a midline shift was observed. MMA embolization before inflammation may not play a role in preventing CSDH development because MMA embolization is considered effective in CSDH because it is associated with the blood supply of neovessels that are newly formed due to inflammation. Therefore, MMA embolization might not be effective in preventing the occurrence of CSDH following craniotomy.
据报道，脑膜中动脉（MMA）血管内栓塞术是治疗慢性硬膜下血肿（CSDH）的有效方法；然而，其对开颅术后CSDH的预防作用尚不清楚。我们报告一例MMA栓塞术未能有效预防开颅术后CSDH的病例。一名56岁男性因复视就诊，被诊断为直径3厘米的蝶骨嵴脑膜瘤。术前进行了MMA栓塞术，并对肿瘤进行了完整的手术切除。术后两个月，患者出现头痛和左侧偏瘫。观察到厚度为15毫米且伴有中线移位的CSDH。炎症前的MMA栓塞术可能无法预防CSDH的发生，因为MMA栓塞术在CSDH中被认为是有效的，这是由于它与因炎症新形成的新生血管的血液供应有关。因此，MMA栓塞术可能无法有效预防开颅术后CSDH的发生。
