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Middle meningeal artery embolization in pediatric patient

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Abstract

Purpose

There is paucity of data in management of recurrent and expanding subdural hematomas (SDH) within the pediatric population, who are otherwise not surgical candidates. Middle meningeal artery (MMA) embolization has been utilized minimally in this population and here, we explore the utility of this procedure in a 15-month-old-child, along with review of the literature.

Methods

A case report of a 15-month-old child who underwent MMA embolization for recurrent and expanding SDH in the setting of anticoagulation for cardiac condition. A literature review of MMA embolization in pediatric patients was conducted.

Results

Initially stabilization of SDH was noted on serial imaging; however, recurrent hemorrhages were noted with subsequent boluses of antiplatelet and anticoagulating agents. There are only 5 total reported cases, included ours, of MMA embolization in pediatrics with an overall success rate of 80%.

Conclusion

Treatment of chronic or recurrent subdural hematoma by MMA embolization in the pediatric population is understudied. Our case notes limitation of this procedure and impact on long-term success, specifically in patients with systemic illness and ongoing anticoagulation.

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Data availability

All data generated or analyzed during this study are included in the article.

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Author information

Authors and Affiliations

  1. Department of Neurological Surgery, University of Illinois Chicago, Chicago, IL, USA

    John Souter

  2. Division of Neurological Surgery, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL, USA

    Mandana Behbahani, Shelly Sharma & Tord D. Alden

  3. Division of Interventional Radiology, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL, USA

    Donald Cantrell

  4. Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL, USA

    Tord D. Alden

  5. Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Tord D. Alden

Authors
  1. John Souter
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  2. Mandana Behbahani
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  3. Shelly Sharma
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  4. Donald Cantrell
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  5. Tord D. Alden
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JS, MB, and SS. The procedure was completed by JS, MB, DC, and TA. TA was the lead surgeon on this case. The first draft of the manuscript was written by JS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tord D. Alden.

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The authors declare no competing interests.

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Souter, J., Behbahani, M., Sharma, S. et al. Middle meningeal artery embolization in pediatric patient. Childs Nerv Syst 38, 1861–1866 (2022). https://doi.org/10.1007/s00381-022-05639-9

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  • DOI: https://doi.org/10.1007/s00381-022-05639-9

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