Middle meningeal artery embolization in pediatric patient

Childs Nerv Syst. 2022 Oct;38(10):1861-1866. doi: 10.1007/s00381-022-05639-9. Epub 2022 Aug 13.

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.

Keywords: Embolization; Middle meningeal artery; Pediatrics; Subdural hematoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Child
  • Embolization, Therapeutic* / methods
  • Hematoma, Subdural, Chronic*
  • Humans
  • Infant
  • Meningeal Arteries / diagnostic imaging

Substances

  • Anticoagulants