• Zhensheng Liu, Youwei Wang, Tieyu Tang, Yunfeng Zhang, Yong Sun, XiongWei Kuang, Tingfeng Wei, Longjiang Zhou, Aijun Peng, Demao Cao, Wang Hongsheng, Wentao Qi, Wu Chenyi, and Qing Shan.
• Department of Interventional Radiology, the Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
• World Neurosurg. 2023 Nov 1; 179: e6e14e6-e14.

ObjectiveWe sought to describe the resolution time of chronic subdural hematoma (CSDH) after middle meningeal artery embolization (MMAE) and potential variables that may affect hematoma resolution.MethodsA retrospective analysis was performed on CSDH patients between December 2018 and December 2021. Patient characteristics, radiologic manifestations, and data of hematoma resolution were recorded. Univariate and multivariate analyses were conducted to identify predictors of CSDH resolution time.ResultsA total of 53 patients were enrolled including 53 hematomas. Only 1 participant relapsed and did not require surgical evacuation. Hematoma resolution was observed in 27 (50.9%) at 4 months and 48 (90.6%) cases at the last radiologic follow-up. The median MMAE-to-resolution time was 19 weeks (interquartile range: 8-24). The burr-hole irrigation + MMAE group showed faster hematoma resolution than MMAE alone during early follow-up periods, but no significant difference was found at 6 months. Increased thickness of residual hematoma, excessive postoperative midline shift, high-density hematoma, mixed-density hematoma, separated hematoma, and anticoagulant or antiplatelet agents used were predictive of nonresolution at 4 months as determined by univariate analysis, whereas anticoagulant or antiplatelet agents used and high-density hematoma were not significant on multivariate analysis. No significant association was noted between hematoma resolution and comorbidities or other hematoma radiologic features.ConclusionsMMAE is an effective and minimally invasive treatment for CSDH with a lower recurrence rate. The median resolution time of CSDH following MMAE was 19 weeks (interquartile range: 8-24). Burr-hole irrigation contributed to early hematoma resolution but had no significant effect at 6 months. In addition, residual hematoma thickness, postoperative midline shift, and specific type of hematoma were associated with delayed hematoma resolution at 4 months.Copyright © 2023 Elsevier Inc. All rights reserved.

19 keywords...

hide…