Department of Neurological Surgery, University of Illinois Chicago, Chicago, IL, USA.
Division of Neurological Surgery, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA.
Childs Nerv Syst. 2022 Oct;38(10):1861-1866. doi: 10.1007/s00381-022-05639-9. Epub 2022 Aug 13.
There is paucity of data in management of recurrent and expanding subdural hematomas (SDH) within the pediatric population, who are otherwise not surgical candidates. Middle meningeal artery (MMA) embolization has been utilized minimally in this population and here, we explore the utility of this procedure in a 15-month-old-child, along with review of the literature.
A case report of a 15-month-old child who underwent MMA embolization for recurrent and expanding SDH in the setting of anticoagulation for cardiac condition. A literature review of MMA embolization in pediatric patients was conducted.
Initially stabilization of SDH was noted on serial imaging; however, recurrent hemorrhages were noted with subsequent boluses of antiplatelet and anticoagulating agents. There are only 5 total reported cases, included ours, of MMA embolization in pediatrics with an overall success rate of 80%.
Treatment of chronic or recurrent subdural hematoma by MMA embolization in the pediatric population is understudied. Our case notes limitation of this procedure and impact on long-term success, specifically in patients with systemic illness and ongoing anticoagulation.
小儿复发性和扩展型硬脑膜下血肿（SDH）的治疗数据很少，这些患儿不适合手术。中脑膜动脉（MMA）栓塞术在该人群中的应用较少，在此，我们通过病例报告探讨了该方法在 15 个月大的患儿中的应用，并对文献进行了回顾。
报告了一例 15 个月大的患儿，因心脏疾病接受抗凝治疗，出现复发性和扩展型 SDH，行 MMA 栓塞术。对 MMA 栓塞术在儿科患者中的应用进行了文献回顾。
连续影像学检查显示 SDH 最初稳定；然而，由于随后使用抗血小板和抗凝药物，再次出现出血。总共只有 5 例儿科 MMA 栓塞术的报道，包括我们的病例，总体成功率为 80%。
MMA 栓塞术治疗小儿慢性或复发性硬膜下血肿的研究较少。我们的病例注意到该手术的局限性及其对长期成功率的影响，特别是在患有系统性疾病和持续抗凝的患者中。
