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Abstract - Case Report

J Cerebrovasc Endovasc Neurosurg. 2020 22(1): 20-25
The Journal of Cerebrovascular and Endovascular Neurosurgery
Middle meningeal artery embolization to treat progressive epidural hematoma: a case report
Tae Joon Park, Sang Pyung Lee, Jinwook Baek, Kyoungsoo Ryou, Seong Hwan Kim
Department of Neurosurgery, Cheju Halla General Hospital, Jeju, Korea

Progressive epidural hematoma is a form of acute epidural hematoma that gradually expands from a small initial hematoma; in cases that are clinically aggravated due to the presence of a mental illness or neurological condition, patients should be surgically treated for evacuation of the hematoma, but poorer outcomes are expected if the patient has several medical co-morbidities for surgery. We experienced two cases of progressive epidural hematoma which were successfully managed by endovascular treatment: an 85-year-old male with medical co-morbidities and a 51-year-old female with a poor-grade subarachnoid hemorrhage resulting from the rupture of a dissecting aneurysm of the vertebral artery. In both cases, a middle meningeal artery embolization was performed and contrast leakage was observed and controlled using cerebral angiography, halting the progression of their epidural hematomas. Thus, endovascular embolization of a middle meningeal artery may play a useful role in salvage therapy in certain complicated situations that limit treatment of the hematoma by surgical evacuation.
Key words : Acute epidural hematoma, Endovascular treatment, Middle meningeal artery embolization, Progressive epidural hematoma

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