Scholarlink

Background <p>Chronic subdural hematoma (CSDH) carries high recurrence rates after surgical evacuation. This study evaluates endovascular middle meningeal artery (MMA) embolization as a minimally invasive alternative for patients with CSDH unsuitable for surgery due to medical contraindications.</p> Methods <p>We retrospectively analyzed 40 consecutive patients with CSDH treated with endovascular MMA embolization using polyvinyl alcohol particles between January 2023 and June 2025. Inclusion criteria: primary or recurrent CSDH with surgical contraindications. Exclusion criteria: acute neurological deterioration requiring urgent decompression. Clinical severity was assessed using the Markwalder grading system. Computed tomography measurements of hematoma thickness (HT) and midline shift were obtained at baseline and 3-month follow-up. Technical success was defined as successful MMA occlusion with preserved normal circulation.</p> Results <p>Among 40 patients (mean age 68.2 ± 11.3&#xa0;years; 70% male), 24 (60%) were Markwalder grade 1 and 16 (40%) grade 2. Technical success was achieved in 38 patients (95%). Mean hematoma thickness decreased significantly from 23.2 ± 5.1 to 5.3 ± 3.8&#xa0;mm (77.1% reduction, p &lt; 0.001). Favorable radiologic outcomes (≥ 50% reduction) occurred in 36 patients (90%), including complete resolution in 15 (37.5%). The mean hospital stay was 2.1 ± 1.2&#xa0;days, with no major complications. MMA diameter was the only significant predictor of a favorable outcome (OR 1.18 per 0.1&#xa0;mm, p = 0.009).</p> Conclusions <p>Endovascular MMA embolization achieves high technical success and favorable short-term outcomes in surgically ineligible patients with CSDH, with significant hematoma reduction and an excellent safety profile.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Endovascular middle meningeal artery embolization for chronic subdural hematoma in surgically ineligible patients: short-term outcomes and safety profile

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月8日

查看全文
  • Mohamed M.A. Zaitoun,
  • Mahmoud M. Taha,
  • Ahmed M. Alawamry,
  • Ahmed Said Fahim,
  • Mona Mahmoud Eladl,
  • Ali M. Hendi,
  • Adel M. Othman,
  • Nahla A. Zaitoun,
  • Talal Abdallah Mohammed,
  • Fahd Alkhamis,
  • Mahmoud Mounir Higazi

摘要

Background

Chronic subdural hematoma (CSDH) carries high recurrence rates after surgical evacuation. This study evaluates endovascular middle meningeal artery (MMA) embolization as a minimally invasive alternative for patients with CSDH unsuitable for surgery due to medical contraindications.

Methods

We retrospectively analyzed 40 consecutive patients with CSDH treated with endovascular MMA embolization using polyvinyl alcohol particles between January 2023 and June 2025. Inclusion criteria: primary or recurrent CSDH with surgical contraindications. Exclusion criteria: acute neurological deterioration requiring urgent decompression. Clinical severity was assessed using the Markwalder grading system. Computed tomography measurements of hematoma thickness (HT) and midline shift were obtained at baseline and 3-month follow-up. Technical success was defined as successful MMA occlusion with preserved normal circulation.

Results

Among 40 patients (mean age 68.2 ± 11.3 years; 70% male), 24 (60%) were Markwalder grade 1 and 16 (40%) grade 2. Technical success was achieved in 38 patients (95%). Mean hematoma thickness decreased significantly from 23.2 ± 5.1 to 5.3 ± 3.8 mm (77.1% reduction, p < 0.001). Favorable radiologic outcomes (≥ 50% reduction) occurred in 36 patients (90%), including complete resolution in 15 (37.5%). The mean hospital stay was 2.1 ± 1.2 days, with no major complications. MMA diameter was the only significant predictor of a favorable outcome (OR 1.18 per 0.1 mm, p = 0.009).

Conclusions

Endovascular MMA embolization achieves high technical success and favorable short-term outcomes in surgically ineligible patients with CSDH, with significant hematoma reduction and an excellent safety profile.