J Neurointerv Surg: Arterial embolism in the meninges can be used as an auxiliary therapy for symptomatic chronic epidural hematoma surgery

Chronic subdural hematoma (CSDH) often requires surgical intervention, however, 15% of cases relapse within one year of treatment.
recent years, arterial (MMA) embolism in the meninges has become a potential treatment to prevent CSDH recurrence.
recently, an article published in BMJ entitled "Middle meningeal artery embolization an adjuvant treatment to surgery for symptomatic chronic subdural hematoma: a pilot assessed study hematoma volume resorption" explores the effects of MMA embolism on postoperative hematoma volume resorption (HVR).
From April 2018 to October 2018, 46 CSDH participants requiring surgery were prospectively randomized and underwent separate surgical treatment (ST group) or surgically assisted MMA embolism (ST-MMAE group).
results were a comparison of HVR measured on a three-month CT scan with an instant CT scan before embolism.
secondary result is a clinical recurrence and safety event of CSDH.
41 patients were followed for three months.
21 patients underwent MMA embolism.
3 months, the level of HVR was higher after the st-MMAE group (average difference of 17.5 mL, 95% CI 3.87 to 31.16 mL; p=0.015).
two participants have a CSDH recurrence (one per group).
one patient died (ST group).
there were no reports of adverse events related to MMA embolism.
, the results show that surgical intervention combined with MMA embolism can increase CSDH re-absorption 3 months after surgery.
1 case of CSDH recurrence was reported in each group, but no treatment-related complications were reported.
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