Dural arteriovenous fistula formation following bilateral middle meningeal artery embolization for the treatment of a chronic subdural hematoma: a case report

2021 ◽  
Author(s):  
Eimad Shotar ◽  
Kevin Premat ◽  
Eric Barberis ◽  
Atika Talbi ◽  
Stéphanie Lenck ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Subdural Hematoma ◽  
Dural Arteriovenous Fistula ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Fistula Formation ◽  
Artery Embolization ◽  
Meningeal Artery

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

2021 ◽  
pp. 1-3
Author(s):  
Dimitri Sigounas ◽  
Kenneth Sack ◽  
George Thomas ◽  
Dimitri Sigounas
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Coil Embolization ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Artery Embolization ◽  
External Circulation ◽  
Meningeal Artery ◽  
Distal Flow

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.

scholarly journals Incidentally discovered dural arteriovenous fistula during middle meningeal artery embolization for the treatment of chronic subdural hematoma

2021 ◽  
Vol 12 ◽  
pp. 438
Author(s):  
Borna Ethan Tabibian ◽  
Elizabeth Liptrap ◽  
Jesse Jones
Keyword(s):  
Arteriovenous Fistula ◽  
Subdural Hematoma ◽  
Dural Arteriovenous Fistula ◽  
Closed Head Injury ◽  
Treatment Strategies ◽  
Chronic Subdural Hematoma ◽  
Rare Condition ◽  
Middle Meningeal Artery ◽  
Presentation Methods ◽  
Meningeal Artery

Background: The incidence of chronic subdural hematoma (CSDH) is increasing with population age and anticoagulant use. Embolization of the middle meningeal artery (MMA) is an emerging, less invasive alternative to open surgery in treating this condition. Dural arteriovenous fistula (DAVF) is a rare condition whose association with CSDH is not well understood. We present three cases with incidentally discovered DAVFs during MMA embolization for the treatment of CSDH that necessitated adjustments to initial treatment strategy. Case Descriptions: We retrospectively reviewed all MMA embolizations performed for the treatment of CSDH beginning in 9/2019 to 11/2020. Imaging and hospital course of three cases of incidentally discovered DAVF, including patient demographics, clinical presentation, methods of treatment, imaging and outcome were assessed. Thirty MMA embolizations were performed as primary or adjunct treatment of CSDH. DAVF was discovered angiographically in 3 (10%) cases. All patients reported a history of prior closed head injury, although the timing of injury and subdural blood product age did not correlate in 2 of the 3 cases. All subjects experienced complete symptomatic and radiographic resolution of the subdural hematoma and DAVF following intervention. Conclusion: As MMA embolization for CSDH becomes more frequent, so may the incidental diagnosis of DAVF. Awareness of this potential association is critical to diagnosing DAVF with angiography and altering treatment strategies as needed.

scholarly journals Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

Radiology ◽  
2018 ◽  
Vol 286 (3) ◽  
pp. 992-999 ◽  
Author(s):  
Seung Pil Ban ◽  
Gyojun Hwang ◽  
Hyoung Soo Byoun ◽  
Tackeun Kim ◽  
Si Un Lee ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Artery Embolization ◽  
Meningeal Artery

Middle meningeal artery embolization for refractory chronic subdural hematoma

2000 ◽  
Vol 93 (4) ◽  
pp. 686-688 ◽  
Author(s):  
Shinya Mandai ◽  
Masaru Sakurai ◽  
Yuzo Matsumoto
Keyword(s):  
Liver Cirrhosis ◽  
Subdural Hematoma ◽  
Therapeutic Approach ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Artery Embolization ◽  
Content Type ◽  
Meningeal Artery ◽  
Fine Print

✓ The authors present a case of refractory chronic subdural hematoma (CSH) in a 59-year-old man with coagulopathy due to liver cirrhosis. The patient was successfully treated by embolization of the middle meningeal artery after several drainage procedures. This new therapeutic approach to recurrent CSH is discussed.

Middle meningeal artery embolization for chronic subdural hematoma: an institutional technical analysis

2020 ◽  
pp. neurintsurg-2020-016552
Author(s):  
Joshua S Catapano ◽  
Andrew F Ducruet ◽  
Candice L Nguyen ◽  
Jacob F Baranoski ◽  
Tyler S Cole ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Complete Resolution ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Artery Embolization ◽  
Embolic Material ◽  
Ethylene Vinyl Alcohol ◽  
Single Center Experience ◽  
Meningeal Artery ◽  
Single Branch

BackgroundRecently, middle meningeal artery (MMA) embolization has emerged as a potentially safe and effective method of treating chronic subdural hematoma (cSDH).ObjectiveTo report a single-center experience with MMA embolization and examines the type of embolic material used, the extent of penetration, and the number of MMA branches embolized.MethodsA retrospective analysis of all patients with MMA embolization from 2018 through 2019 was performed. A failed outcome was defined as either surgical rescue and/or greater than 10 mm of hematoma residual or reaccumulation following embolization.ResultsOf 35 patients, surgery had failed for 9 (26%) and initial conservative treatment had failed for 6 (17%). Of 41 MMA embolizations, including those in six patients with bilateral cSDH who underwent bilateral MMA embolization, 29 (72%) were performed using ethylene vinyl alcohol copolymer (Onyx), 7 (17%) using particles, and 5 (12%) using n-butyl cyanoacrylate. Both the anterior and posterior MMA divisions were embolized in 29 cases (71%); distal penetration of these branches was achieved in 25 embolizations (61%). Twenty-six (63%) cSDHs completely resolved. Complete resolution was seen in 22 of 29 hematomas (76%) in which both anterior and posterior MMA branches were occluded versus 4 of 12 (33%) following single-branch embolization (p=0.014). Embolization of one cSDH (2%) failed.ConclusionMMA embolization of cSDHs appears to be both safe and efficacious. Furthermore, embolization of both the anterior and posterior MMA branches may be associated with increased odds of complete resolution.

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