Clinical Study On The Treatment Of Chronic Subdural Hematoma By Drilling And Drainage Combined With Middle Meningeal Artery Embolization

Objectives:To evaluate the safety and efficacy of trephination and drainage combined with middle meningeal artery(MMA)embolization in the treatment of chronic subdural hematoma(CSDH),and to compare the efficacy and safety of trephination and drainage alone in the treatment group.Methods:Collect patients diagnosed with CSDH admitted to the Second Affiliated Hospital of Nanchang University from January 2020 to December 2022,and divide them into two groups based on their treatment status: A group received drilling drainage combined with MMA embolization,and B group received simple drilling drainage.Statistical analysis was conducted on the baseline characteristics of patients,perioperative complications,symptoms and signs at discharge,reoperation rate,and imaging results during follow-up.Results:Among the 24 cases,12 cases(50%)were treated with drilling drainage combined with MMA embolization,of which 4 cases were bilateral subdural hematomas,while 12 cases(50%)were treated with drilling drainage alone,of which 3 cases were bilateral subdural hematomas.There were no statistically significant differences between the two groups in age,gender,initial hematoma thickness,previous medical history,and preoperative m RS grading.During the follow-up period,no recurrence was found in the patients in the drilling drainage combined with MMA embolization group.During the follow-up period,there were 4 cases(33.3%)of recurrence in the patients in the simple drilling drainage group,with one patient experiencing bilateral hematoma recurrence and another patient undergoing drilling drainage after recurrence.Currently,the patient has recovered well.There was a significant difference in recurrence rate between the two groups of patients(P=0.028,<0.05),but there was no statistically significant difference in mRS scores at discharge and during follow-up,and neither group of patients had any surgical related complications during the perioperative period.Conclusions:The combination of drilling drainage and MMA embolization can effectively reduce the recurrence rate of chronic subdural hematoma compared to simple drilling drainage.Moreover,patients who receive drilling drainage and MMA embolization have no significant difference in the incidence of surgical related complications compared to the simple drilling drainage treatment group.Therefore,drilling drainage and MMA embolization is a safe and effective treatment method.