Repeated Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Management: Case Report

Author Info

Kenneth Sack George Thomas Dimitri Sigounas

Corresponding Author

Dimitri Sigounas
Department of Neurosurgery, George Washington University, Washington, D.C., USA

A B S T R A C T

Aim: Middle Meningeal Artery (MMA) embolization has emerged as a viable neuroendovascular technique for the management of chronic subdural hematoma (SDH). Comparative analysis of various endovascular techniques for embolization is lacking. Guidance on operative techniques in situations of prior embolization failure is rare. Materials and Methods: In this case report, we present a patient with a chronic subdural hematoma that failed previous coil embolization of the MMA. Digital Subtraction Angiography showed the previously placed coil and continued distal flow to the dural membranes. Results: Onyx liquid embolization was completed successfully, effectively halting both anterograde flow to the MMA and retrograde flow from external circulation collaterals. Conclusion: This case report suggests that in situations of MMA embolization failure, follow-up angiography may be completed to determine if further embolization through other procedural techniques may be possible. The angiographic images contained here highlight the advantages of liquid embolization over coil embolization of the MMA in halting SDH angiogenesis.

Article Info

Article Type

Case Report

Publication history

Received: Wed 11, Aug 2021
Accepted: Wed 25, Aug 2021
Published: Fri 03, Sep 2021

Copyright

© 2023 Dimitri Sigounas. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.CRSS.2021.02.02