Middle meningeal artery embolization in the management of chronic subdural hematoma in medically complex pediatric neurosurgical patients: technical note.

Autor:	Coyle AM; 1Division of Neurosurgery, Children's Hospital of Philadelphia.; 2Department of Neurosurgery, Temple University, Philadelphia., Graves EKM; 2Department of Neurosurgery, Temple University, Philadelphia., Lang SS; 1Division of Neurosurgery, Children's Hospital of Philadelphia.; Departments of3Neurosurgery and., Kennedy BC; 1Division of Neurosurgery, Children's Hospital of Philadelphia.; Departments of3Neurosurgery and., Flanders TM; 1Division of Neurosurgery, Children's Hospital of Philadelphia.; Departments of3Neurosurgery and., Tucker AM; 1Division of Neurosurgery, Children's Hospital of Philadelphia.; Departments of3Neurosurgery and., Storm PB; 1Division of Neurosurgery, Children's Hospital of Philadelphia.; Departments of3Neurosurgery and., Cahill AM; 4Division of Interventional Radiology, Children's Hospital of Philadelphia, Pennsylvania.; 5Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia; and., Pukenas BA; Departments of3Neurosurgery and.; 5Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia; and., Madsen PJ; 1Division of Neurosurgery, Children's Hospital of Philadelphia.; Departments of3Neurosurgery and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2023 Sep 01; Vol. 32 (5), pp. 617-622. Date of Electronic Publication: 2023 Sep 01 (Print Publication: 2023).
DOI:	10.3171/2023.7.PEDS2345
Abstrakt:	Middle meningeal artery (MMA) embolization has gained acceptance as a treatment for chronic subdural hematoma (cSDH) in adult patients but has not been well described in pediatric patients. Standard cSDH treatment has historically consisted of burr hole drainage with or without subdural drain placement. However, due to the high rate of recurrence and frequency of comorbidities within this population, as both pediatric and adult patients with cSDH frequently have concurrent cardiac disease and a need for anticoagulant therapies, MMA embolization has increasingly demonstrated its value as both an adjunctive and primary treatment. In this report, the authors present 3 cases of successful MMA embolization in medically complex children at a single institution. MMA embolization was used as a primary treatment modality and as an adjunctive therapy in the acute setting following surgical hematoma evacuation. Two patients were receiving anticoagulation treatment requiring reversal. Technical considerations specific to the pediatric population as well as those common to both the pediatric and adult populations are addressed. Further work is needed to define the optimal indications and outcomes for MMA embolization in children with cSDH.
Databáze:	MEDLINE
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