Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Efficacy of Middle Meningeal Artery Embolization in Treatment Resistant Spontaneous Intracranial Hypotension Caused Subdural Hematoma : Report of Two Cases and Review of the Literature

  • Evran, Sevket (Department of Neurosurgery, Haseki Training and Research Hospital, University of Health Sciences) ;
  • Kayhan, Ahmet (Department of Neurosurgery, Haseki Training and Research Hospital, University of Health Sciences) ;
  • Saygi, Tahsin (Department of Neurosurgery, Haseki Training and Research Hospital, University of Health Sciences) ;
  • Ozbek, Muhammet Arif (Department of Neurosurgery, Istanbul Medipol University) ;
  • Kilickesmez, Ozgur (Department of Radiology, Basaksehir Cam And Sakura City Hospital)
  • Received : 2022.03.19
  • Accepted : 2022.05.03
  • Published : 2022.11.01
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Abstract

Spontaneous intracranial hypotension (SIH) most commonly manifests as bilateral subdural hematoma (SH). SIH cases mostly resolve spontaneously but further treatment would be needed via blind epidural blood patch (EBP). Cerebrospinal fluid (CSF) leakage in EBP-refractory cases can be treated surgically only if the localization of CSF leakage is detectable but it cannot be possible in most of the cases. Also surgical evacuation of SH secondary to SIH (SH-SIH) is not favorable without blocking the CSF leakage. Thus the management of these patients is a challenge and alternative treatment options are needed. Although middle meningeal artery embolization (MMAE) is an effective treatment option in non-SIH SH, there is no report about its application in the treatment of SH-SIH. We present two cases of SH-SIH which their clinical and radiological findings were completely resolved by bilateral MMAE treatment.

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References

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