title: Usefulness of interventional embolization of the middle meningeal artery for recurrent chronic subdural hematoma: Five cases and a review of the literature.
abstract: OBJECTIVE
  Although several strategies against recurrent chronic subdural hematoma (CSDH) have been proposed, no consensus has been established. Recently, middle meningeal artery (MMA) embolization has been proposed as radical treatment for recurrent CSDH. We wanted to estimate the usefulness of MMA embolization for recurrent CSDH.
  
  
  METHODS
  From February 2012 to June 2013, 110 patients with CSDH underwent single burr-hole surgery with irrigation and drainage. Among these patients, 13 showed recurrent hematoma formation and were retreated surgically. Furthermore, repeated recurrence of CSDH was observed in six patients. Five of these six patients underwent middle meningeal artery (MMA) embolization with polyvinyl alcohol particles. All five patients with interventional treatment were observed for four to 60 weeks.
  
  
  RESULTS
  No more recurrence of CSDH was observed in any of the patients. During the follow-up period, no patients suffered from any side effects or complications from the interventional treatment.
  
  
  CONCLUSIONS
  MMA embolization with careful attention paid to the procedure might be a treatment of choice for recurrent CSDH.
authors.affiliation: Department of Neurosurgery, Hokuto Hospital, Japan tenpaku@hokuto7.or.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Tempaku
authors.affiliation: Department of Neurosurgery, Hokuto Hospital, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamauchi
authors.affiliation: Department of Neurosurgery, Hokuto Hospital, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Ikeda
authors.affiliation: Department of Neurosurgery, Hokuto Hospital, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Tsubota
authors.affiliation: Department of Neurosurgery, Hokuto Hospital, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Furukawa
authors.affiliation: Department of Neurosurgery, Hokuto Hospital, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Maeda
authors.affiliation: Department of Neurological Medicine, Hokuto Hospital, Japan.
authors.forename: Kimito
authors.initials: K
authors.lastname: Kondo
authors.affiliation: Department of Neurosurgery, Hokuto Hospital, Japan.
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nishio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008576:Meningeal Arteries; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D012008:Recurrence; D019233:Retreatment
chemical_list: D011142:Polyvinyl Alcohol
keywords: Chronic subdural hematoma; embolization; middle meningeal artery