脑膜中动脉栓塞治疗高危复发性慢性硬膜下血肿

目的 观察脑膜中动脉栓塞（MMAE）治疗高危复发性慢性硬膜下血肿（HR-CSDH）的有效性及安全性。方法 回顾性分析12例接受MMAE治疗的HR-CSDH患者，其中10例单侧CSDH、2例双侧CSDH，观察治疗效果及并发症。结果 5例首次诊断HR-CSDH患者于钻孔引流术后次日接受MMAE；4例首次诊断HR-CSDH但未达外科钻孔引流术指征者接受单纯MMAE；3例钻孔引流术后复发HR-CSDH患者中，1例于MMAE后次日接受再次钻孔引流术，2例接受单纯MMAE。MMAE中，共栓塞14支脑膜中动脉（MMA），均栓塞成功。术后6个月内头部CT显示10例（11侧）CSDH血肿完全吸收，2例（3侧）CSDH血肿厚度缩小>50%，未见血肿增大进展者，均无需进一步外科处理。随访期间临床症状均有不同程度改善甚至消失，未见MMAE相关并发症。结论 MMAE治疗HR-CSDH安全、有效。

Middle meningeal artery embolization for treatment of chronicsubdural hematoma with high risk of recurrence

Objective To explore the efficacy and safety of middle meningeal artery embolization (MMAE) for treatment of chronic subdural hematoma with high risk of recurrence (HR-CSDH). Methods Data of 12 patients with HR-CSDH (unilateral CSDH in 10 patients and bilateral CSDH in 2 patients) treated with MMAE were retrospectively analyzed, and the therapeutic effect and complications were observed. Results Five cases first diagnosed as HR-CSDH received prophylactic MMAE on the next day of burr hole drainage, 4 cases first diagnosed as HR-CSDH but didn''t meet the indication of surgical burr hole drainage received MMAE alone. Recurrence of HR-CSCD happened in 3 cases after burr hole drainage, among them 1 case underwent burr hole drainage again on the next day of MMAE, and the rest 2 cases received MMAE alone. Totally 14 branches of middle meningeal artery (MMA) were successfully embolized. Complete resolution was achieved in 11 CSDH of 10 cases, while size reduction >50% was observed in 3 CSDH of 2 cases on head CT within 6 months. No further surgical management was needed. During follow-up period, the clinical symptoms improved in varying degrees or even disappeared, and no MMAE related complications occurred. Conclusion MMAE was safe and effective for treating HR-CSDH.