Repeated Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Management: Case Report
2021
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.
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