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Head and neck
Case report
Republished: Resolution of an enlarging subdural haematoma after contralateral middle meningeal artery embolisation
  1. Caleb Rutledge,
  2. Jacob F Baranoski,
  3. Joshua S Catapano,
  4. Ashutosh P Jadhav,
  5. Felipe C Albuquerque,
  6. Andrew F Ducruet
  1. Department of Neurosurgery, Barrow Neurological Institute, St Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA
  1. Correspondence to Dr Andrew F Ducruet; neuropub{at}barrowneuro.org

Abstract

A man in his 50s presented 1 month after an automobile accident with worsening headaches and an enlarging chronic left subdural haematoma (SDH). He underwent left middle meningeal artery (MMA) embolisation. Due to tortuosity at its origin, we were unable to catheterise the MMA distally. Only proximal coil occlusion at the origin was performed. Follow-up interval head CT showed an increase in the size of the SDH with new haemorrhage, worsening mass effect and midline shift. However, he remained neurologically intact. Contralateral embolisation of the right MMA was performed with a liquid embolic agent. His headaches improved, and a follow-up head CT 3 months later showed near-complete resolution of the SDH.

  • subdural
  • angiography
  • liquid embolic material
  • meninges
  • technique

https://doi.org/10.1136/neurintsurg-2021-017530.rep

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    Footnotes

    • Presented at Republished with permission from BMJ Case Reports. Published 26/01/2021. Here are the cases details Apr 2021, 14 (4) e017439; doi: 10.1136/bcr-2021-017530

    • Contributors CR: writing. JFB: editing. JSC: editing. APJ: conception/editing. FCA: conception/editing. AFD: conception/editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests AFD is a consultant for Penumbra, Stryker, Medtronic, Cerenovus and Koswire; and serves on the editorial board of Journal of NeuroInterventional Surgery. FCA and APJ serve on the editorial board of Journal of NeuroInterventional Surgery. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this manuscript.

    • Provenance and peer review Not commissioned; externally peer reviewed.