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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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MMA embolisation for chronic subdural haematoma

Evaluierung der AMM-Embolisierung bei cSDH

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  • presenting/speaker Rami Ajaaj - Asklepios Schildautalkliniken Seesen, Klinik für Neurochirurgie, Seesen, Deutschland
  • Abdelrazek Hamed - Asklepios Schildautalkliniken Seesen, Klinik für Neurochirurgie, Seesen, Deutschland
  • Matthias Kirsch - Asklepios Schildautalkliniken Seesen, Klinik für Neurochirurgie, Seesen, Deutschland
  • Ralf Becker - Asklepios Schildautalkliniken Seesen, Klinik für Neurochirurgie, Seesen, Deutschland
  • Carlo Morgenroth - Asklepios Schildautalkliniken Seesen, Klinik für Neurochirurgie, Seesen, Deutschland
  • Kai Kallenberg - Asklepios Schildautalkliniken Seesen, Klinik für Neurochirurgie, Seesen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV030

doi: 10.3205/21dgnc032, urn:nbn:de:0183-21dgnc0320

Published: June 4, 2021

© 2021 Ajaaj et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The aim of this study was to assess the value of ipsilateral meningeal artery (MMA) embolisation after burr hole evacuation of chronic subdural hematoma (cSDH).

Methods: Retrospective study to compare post-interventional results (i.e. recurrence rate and complications) of cSDH after burr hole evacuation and consecutive embolisation of MMA versus a historic control group of only burr hole evacuated patients.

91 embolized patients (2018-2020) versus 142 non-embolized patients (2015-2017) were compared.

Results: Embolized versus non-embolized patients showed the following distributon of parameters and outcomes:

med. age: 79 vs. 76.6 years; m/w ratio: 67 / 33% vs. 35.2 / 64.8%; pre-op symptoms : cephalgia: 57 vs. 47.2%; hemisympt.: 53 vs. 51%; aphasia: 26,4 vs. 28.2%; seizures: 5.5 vs. 7.7%; anamnestic trauma: 56 vs.57%.

Post-op/post-interventional: complications and morbitity post-op 13.2 vs. 41.5%; mortality 1,1 vs.4,2%; median hospital stay: 10 vs. 13.1 days.

Twelve weeks after treatment, an ambulatory assessment was completed and revealed: recurrence rate of 9.8 vs. 31.7% (p<0.01), refractory cSDH requiring re-operation 0% vs. 9.3%, peri-operative seizures 1.1 vs. 13%; post-op pneumonia: 1,1 vs. 9%, pulmonary embolism 1.1% vs. 0%. The average modified Rankin scale assessment changed from 2.0 pre-op to 0.3 post-op.

Conclusion: Selective AMM-embolisation was an effective adjunct treatment in addition to burr hole evacuation leading to a dramatic decrease of recurrent cSDH and lowered the overall complication rate.