Endovascular embolization of the middle meningeal artery with the SQUID-18 non-adhesive embolic agent as a treatment for recurrent chronic subdural hematoma (a case report)

Objective: to report a case of recurrent chronic subdural hematoma treated using endovascular superselective embolization of the middle meningeal artery with the SQUID-18 non-adhesive embolic agent. Materials and methods. A 73-year-old male patient had an open head injury after own height falling. Multislice computed tomography demonstrated chronic subdural hematoma in the left parietooccipital region. The patient had surgery with a positive effect; however, 1 month postoperatively he developed recurrent hematoma. He was diagnosed with recurrent chronic subdural hematoma and underwent endovascular embolization of the distal branches of the middle meningeal artery with a non-adhesive embolic agent; repeated hematoma drainage was not required. Results. Follow-up multislice computed tomography performed 7 months postoperatively demonstrated total resorption of chronic subdural hematoma. Conclusion. This case illustrates the variety of methods that can be used for the treatment of chronic subdural hematoma and shows that endovascular embolization of the middle meningeal artery is a minimally invasive and effective procedure for such a disorder.