Treatment of Chronic Subdural Hematomas by Clipping of Arteria Meningia Media

Introduction: Although chronic subdural hematomas are frequently curable with classical surgical treatment methods, recurrent cases after surgical treatment are not uncommon. There are only a few reports in the literature that mention treatment of recurrent subdural hematomas by embolization of arteria meningia media, which supply the outer membrane of the hematoma. Methods: We prospectively analyzed 27 (10 female and 17 male) chronic subdural hematoma cases that were treated in our clinic. The average age of the patients was 64 years in a range of 46 to 88 years. Twenty of the cases had a previous head trauma history. We treated 13 of the cases with only drainage of the hematoma with burr-holes. We clipped the ipsilateral arteria meningia media in addition to the drainage of the hematoma with burr-holes in the other 14 patients. We compared the average drainage time and the total amount of hematoma collected during the drainage period after surgery. We also checked the total protein, albumin, and globuline levels in the drainage material. A control cranial computerized tomography was done in all cases on the 20th postoperative day. Results: Less drainage material and lower albumin and globuline levels in the drainage material were found in the cases where the arteria meningia media were clipped. But the results were not statistically significant (p > 0.05–Wilcoxon). Conclusion: Clipping of arteria meningia media might be helpful for the treatment of recurrent chronic subdural hematomas.