Kulhari Ashish, Fourcand Farah, Singh Amrinder, Zacharatos Haralabos, Mehta Siddhart, Kirmani Jawad F
Neurology, University of Missouri Kansas City School of Medicine, Kansas City, USA.
Medicine, Kansas City University of Medicine and Biosciences, Kansas City, USA.
Cureus. 2023 Apr 26;15(4):e38164. doi: 10.7759/cureus.38164. eCollection 2023 Apr.
Subdural hemorrhage (SDH) is a common neurological disease. In past, SDHs were managed either conservatively (non-surgically) or with surgical evacuation (burr hole versus craniotomy) depending on the severity. Surgical evacuation has major challenges including high recurrence rate, stoppage and reversal of antiplatelet or anticoagulation agents, risk of general anesthesia and surgery in elderly patients with multiple comorbidities. Given the above challenges, embolization of the distal branches of the middle meningeal artery (MMA) has recently emerged as an excellent alternate to surgical evacuation or conservative management. To the best of our knowledge, there is no literature on the embolization of the deep temporal artery (DTA) for subacute-chronic SDH. We report the first case of recurrent subdural hematoma post MMA embolization that was successfully treated with embolization of DTA.
硬膜下血肿(SDH)是一种常见的神经系统疾病。过去,根据严重程度,硬膜下血肿的治疗方法要么是保守治疗(非手术治疗),要么是手术清除(钻孔引流术与开颅手术)。手术清除面临重大挑战,包括高复发率、停用和逆转抗血小板或抗凝药物、老年合并多种疾病患者的全身麻醉和手术风险。鉴于上述挑战,脑膜中动脉(MMA)远端分支栓塞术最近已成为手术清除或保守治疗的一种极佳替代方法。据我们所知,尚无关于颞深动脉(DTA)栓塞治疗亚急性 - 慢性硬膜下血肿的文献报道。我们报告了首例脑膜中动脉栓塞术后复发性硬膜下血肿经颞深动脉栓塞成功治疗的病例。