Comparison of clinical efficacy of MMA Embolization combined with subdural perforation drainage and subdural perforation drainage in the treatment of CSDH

Neurocirugia (Astur : Engl Ed). 2024 Nov 15:S2529-8496(24)00067-4. doi: 10.1016/j.neucie.2024.11.001. Online ahead of print.

Abstract

Background: Chronic subdural hematoma is a frequent neurosurgical illness, and current treatment options mostly include subdural trepanation and drainage alone, as well as middle meningeal artery embolization in conjunction with subdural trepanation and drainage. However, there is currently a lack of extensive study and data support for comparing the clinical results of the two surgical treatment techniques.

Objective: The goal of this study is to compare the clinical effects of middle meningeal artery embolization combined with subdural trepanation and drainage versus simple subdural trepanation and drainage in the treatment of chronic subdural hematoma, in order to provide a reliable foundation for clinical selection of appropriate surgical treatment methods.

Methods: This study included 71 patients with chronic subdural hematoma, who were divided into two groups according to the procedure: observation group (n = 25) and control group (n = 46). The control group received only basic subdural drilling and drainage.

Conclusions: This study found that MMA embolization combined with subdural trepanation and drainage provides a greater therapeutic benefit in the treatment of chronic subdural hematoma. The observation group outperformed the control group in terms of postoperative CT results, Barthel index, and clinical effect, as well as operating time. Furthermore, the observation group's complications and recurrence rate were much lower than the control group's.

Keywords: Chronic subdural hematoma; Clinical effect; Efecto clínico; Embolización de la arteria media meningeal; Hematoma subdural crónico; Middle meningeal artery embolization; Método quirúrgico; Subdural drilling and drainage; Surgical method; drenaje por perforación subdural.