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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:1177-1180, August 2004
© 2004 American Society of Neuroradiology

INTERVENTIONAL

Efficacy of Endovascular Surgery for the Treatment of Acute Epidural Hematomas

Sachio Suzuki^a, Masataka Endo^b, Akira Kurata^a, Taketomo Ohmomo^a, Hidehiro Oka^a, Takao Kitahara^b, Takashi Ohwada^b, Satoshi Utsuki^a and Kiyotaka Fujii^a

^a Department of Neurosurgery, Kitasato University School of Medicine, Kanagawa, Japan
^b Department of Critical Care Medicine, Kitasato University School of Medicine, Kanagawa, Japan

Address reprint requests to Sachio Suzuki, MD, Department of Neurosurgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa, 228-8555, Japan

BACKGROUND AND PURPOSE: Recent advances in the equipment and technology for endovascular surgery have led to an increasing number of patients undergoing this procedure to treat various lesions. The purpose of this study was to investigate the efficacy of early-stage endovascular surgery to treat growing acute epidural hematomas (AEDHs).

METHODS: Over a period of 2.5 years, endovascular intervention was performed in nine patients with AEDHs, as shown by the extravasation of contrast medium and the recognition of growing hematomas on CT scans. Embolization was performed by using catheters superselectively advanced with a microguidewire until it reached the area just before the bleeding point.

RESULTS: In all nine cases, bleeding from the middle meningeal artery ceased immediately after treatment, and further surgical intervention was avoided. In three of five patients with additional lesions, surgical intervention was also conducted to treat an acute subdural hematoma (two patients) or a contusion hematoma (one patient); in two cases, these lesions were located on the contralateral side.

CONCLUSION: In patients with thin AEDHs in the early stage, angiography followed by endovascular intervention allows for conservative treatment. Notable clinical benefits can be achieved in patients with complicated, multiple lesions.