Surgical occlusion of middle meningeal artery in treatment of chronic subdural haematoma: anatomical and technical considerations

Haldrup, Mette; Munyemana, Paulin; Ma'aya, Alhareth; Jensen, T. S.; Fugleholm, Kåre

doi:10.1007/s00701-021-04754-x

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Previous studies have reported that vessels from the MMA can pass through the dura mater and link with emerging neovessels in the external CSDH membrane. Consequently, MMA appears to have a significant influence on the genesis of CSDH and its recurrence, given the vulnerability of these neovessels ( 6 ). There is a growing belief that primary expansion and reoccurrence of CSDH are influenced by blood supply to these membranes.…”

Section: Discussionmentioning

confidence: 99%

“…Haldrup et al ( 6 ) reported that CSDH mainly occurs in the anterior region and is predominantly supplied by the anterior branch of the MMA. They also found that deliberate occlusion of the anterior branch of the MMA during a burr hole procedure can reduce the recurrence rates of CSDH, suggesting that similar MMA coagulation during pterional craniotomy influences the occurrence of postoperative CSDH following unruptured aneurysm surgery ( 6 ). This finding indicates the potential impact of anterior MMA management on postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The middle meningeal artery (MMA), which is commonly cauterized during pterional craniotomy, supplies the outer membrane of CSDH and significantly contributes to the neovascularization of the membrane associated with CSDH ( 6 , 7 ). Furthermore, previous studies have shown that CSDH mainly occurs in the anterior region and is predominantly supplied by the anterior branch of the MMA, and MMA occlusion during burr hole procedures can reduce the recurrence rates of CSDH ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Kim

2024

Front. Neurol.

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BackgroundAlthough microsurgical clipping for unruptured aneurysms has become safer and more efficient with modern neurosurgical advances, postoperative chronic subdural hematoma (CSDH) persists as an underrecognized complication. This study investigated the association between preservation of the anterior branch of the middle meningeal artery (MMA) during surgery and CSDH development.MethodsWe retrospectively reviewed 120 patients who underwent clipping for unruptured aneurysms at Kyungpook National University Chilgok Hospital between May 2020 and July 2023. We evaluated the patients on the basis of surgical approach—lateral supraorbital (LSO) or standard pterional craniotomy—and the status of the MMA postoperatively. We employed pre-and post-operative MR angiography to assess MMA preservation and used follow-up computed tomography scans to monitor CSDH development.ResultsOf the 120 patients, 22 (18.3%) developed CSDH. Univariate analysis revealed that male sex, advanced age, and MMA preservation are risk factors for postoperative CSDH. Multivariate analysis supported these findings, indicating a significant association with the development of CSDH. MMA preservation was reported in 65 patients, of whom 60 and 5 underwent LSO and pterional craniotomy, respectively.ConclusionPreservation of the anterior branch of the MMA during unruptured aneurysm surgery is a risk factor for postoperative CSDH development. Advanced age and male sex also contribute to the increased risk. These findings highlight the need for further investigation into surgical techniques that could mitigate postoperative CSDH development.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Kim

2024

Front. Neurol.

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“…Diagnosen stilles ved CT eller MR-skanning, og den primaere behandling i Danmark er kirurgisk fjernelse via et borhul. Proceduren foretages på en af landets fire neurokirurgiske afdelinger [10,11] (Figur 1 Figur 1). Den store stigning i antallet af patienter har medført, at operation for KSDH er et af de hyppigste kraniekirurgiske indgreb i Danmark.…”

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Treatment of chronic subdural haematoma

Jensen,

Grønhøj,

Miscov

et al. 2024

Ugeskr Læger

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A further rise in chronic subdural haematoma (CSDH) prevalence is expected with an ageing population, and evidence-based guidelines are needed to direct treatment, while creating a platform for research. The Danish Chronic Subdural Hematoma Study (DACSUHS) has implemented the first Danish national CSDH guidelines in 2018 and have standardised CSDH management on a national level. Based on CSDH literature published between 2016 and 2022, these guidelines were updated in 2022. The updated guidelines are presented in this review.

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A systematic review of middle meningeal artery embolization for minimally symptomatic chronic subdural haematomas that do not require immediate evacuation

Rojas-Villabona,

Mohamed,

Kennion

et al. 2023

Brain and Spine

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Surgical occlusion of middle meningeal artery in treatment of chronic subdural haematoma: anatomical and technical considerations

Cited by 4 publications

References 8 publications

Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Treatment of chronic subdural haematoma

A systematic review of middle meningeal artery embolization for minimally symptomatic chronic subdural haematomas that do not require immediate evacuation

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