neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2020-22-1-65-70neurosurgery-836Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEЭндоваскулярная эмболизация средней оболочечной артерии в лечении резидуальной хронической субдуральной гематомы (наблюдение из практики)Endovascular embolization of the left middle meningеal artery for residual chronic subdural hematoma (clinical case)https://orcid.org/0000-0003-3915-7796ПасхинД. Л.PaskhinD. L.

115516 Москва, ул. Бакинская, 26

26 Bakinskaya St., Moscow 115516

yas-moe@mail.ruhttps://orcid.org/0000-0002-8649-2610ПакВ. В.PakV. V.

115516 Москва, ул. Бакинская, 26

26 Bakinskaya St., Moscow 115516

https://orcid.org/0000-0003-0951-908XМиронковА. Б.MironkovA. B.

115516 Москва, ул. Бакинская, 26

26 Bakinskaya St., Moscow 115516

https://orcid.org/0000-0001-8472-4249АсратянС. А.AsratyanS. А.

115516 Москва, ул. Бакинская, 26

26 Bakinskaya St., Moscow 115516

https://orcid.org/0000-0001-5867-5519ШурыгинС. Н.ShuryginS. N.

115516 Москва, ул. Бакинская, 26

26 Bakinskaya St., Moscow 115516

ГБУЗ «Городская клиническая больница им. В. М. Буянова Департамента здравоохранения г. Москвы»РоссияMoscow City Clinical Hospital n. a. V. M. Buyanov, Moscow Healthcare DepartmentRussian Federation2020110420202216570Copyright © Пасхин Д.Л., Пак В.В., Миронков А.Б., Асратян С.А., Шурыгин С.Н., 20202020Пасхин Д.Л., Пак В.В., Миронков А.Б., Асратян С.А., Шурыгин С.Н.Paskhin D.L., Pak V.V., Mironkov A.B., Asratyan S.А., Shurygin S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/836

Цель работы – представить описание случая успешного эндоваскулярного лечения резидуальной хронической субдуральной гематомы.

Клиническое наблюдение

Клиническое наблюдение. Пациент А., 77 лет, поступил в стационар с направительным диагнозом острого нарушения мозгового кровообращения. При обследовании выявлена левополушарная хроническая субдуральная гематома объемом 100 см3. Дважды выполнено закрытое наружное дренирование гематомы. И при каждой последующей контрольной компьютерной томографии наблюдалась резидуальная гематома с объемным воздействием на головной мозг. Проведена эндоваскулярная селективная эмболизация средней оболочечной артерии слева. При обследовании через 5 мес подтверждено полное исчезновение гематомы, общемозговой и очаговой неврологической симптоматики.

Заключение

Заключение. Эндоваскулярная эмболизация средней оболочечной артерии может составить патогенетически обоснованную малоинвазивную альтернативу повторным оперативным вмешательствам при резидуальных и рецидивных субдуральных гематомах. Целесообразно продолжить исследования по оценке эффективности и безопасности этого метода.

The objective is to describe the case of successful endovascular treatment of residual chronic subdural hematoma.

Clinical case

Clinical case. Patient A., 77 years old, was admitted to the hospital with a directional diagnosis of stroke. During further examination, left hemispheric chronic subdural hematoma with a volume of 100 cm3 was revealed. The patient was twice performed closed external drainage of hematoma. And for each subsequent control computed tomography studies, a residual hematoma with a volume effect on the brain was determined. Endovascular selective embolization of the left middle meningеal artery was performed. During the examination after 5 months, a complete reduction of hematoma, cerebral and focal neurological symptoms was noted.

Conclusion

Conclusion. Endovascular embolization of the middle meningeal artery may be a pathogenetically substantiated, minimally invasive alternative to repeated surgical interventions for residual and recurrent chronic subdural hematoma. It will be reasonable to continue research to assess the effectiveness and safety of the methodology.

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The authors declare that there are no conflicts of interest present.