EDUCATION AND TRAINING
cSDH: Leading with Evidence
cSDH is predicted to become the most common cranial neurosurgical condition among adults by 20301. Medtronic is committed to facilitating multi-disciplinary collaboration in the treatment of cSDH, and supporting physicians to treat as many sufferers as possible.
What is Chronic Subdural Haematoma (cSDH)?
A subdural haematoma (SDH) is a collection of blood between the arachnoid mater & dura mater, that typically develops as a result of trauma. Chronic (cSDH) refers to a haematoma that doesn't dissipate 21+ days post-trauma, with a propensity to recur after surgical evacuation2,3. It carries a high morbidity, mortality, and healthcare resource burden4.
Existing medical and surgical treatments, as the mainstay treatment for cSDH, demonstrate recurrence rates of up to 20%5 and reoperation rates of 12%6. Middle meningeal artery (MMA) embolisation is an emerging minimally-invasive adjunctive procedure to surgery that has the advantage of targeting the vascular supply of the subdural haematoma3.
The results of three randomised trials (EMBOLISE, Magic-MT and STEM) provide, for the first time, level 2 evidence of the clinical benefit of MMA embolisation with liquid embolics for the treatment of cSDH7.
Neurovascular community knowledge sharing
Dr. Vinicius Carraro do Nascimento
The EMBOLISE Trial
Dr Vinicius Carraro do Nascimento discusses the results of the EMBOLISE Trial and how he believes this will impact the field of interventional neuroradiology.
A/Prof. Julian Maingard
MMA Embolisation for cSDH: An Effective Treatment with a Bright Future
Associate Professor Julian Maingard provides an overview of cSDH, imaging and clinical considerations, the available evidence for treatment of cSDH, and how he peforms MMA embolisation including case examples.
Education Resources
Explore resources including clinical data summaries, product information and tips & tricks, and material for support staff and patients.
References
1
Balser, D., Farooq, S., Mehmood, T., Reyes, M., & Samadani, U. (2015). Actual and projected incidence rates for chronic subdural hematomas in United States Veterans Administration and civilian populations. Journal of neurosurgery, 123(5), 1209–1215. https://doi.org/10.3171/2014.9.JNS141550.
2
DynaMed. Subdural Hematoma. EBSCO Information Services. Accessed July 15, 2024. https://www.dynamed.com/condition/subdural-hematoma
3
Rudy, R., Catapano, J., Jadhav, A., Albuquerque, F., Ducruet, A. (2022). Middle Meningeal Artery Embolization to Treat Chronic Subdural Hematoma. https://www.ahajournals.org/doi/10.1161/SVIN.122.000490
4
Hendrix P, Goren O, Dalal S, et al. In-hospital mortality rates, complication rates, length of stay, and total costs of >14,000 chronic subdural hematomas treated in the U.S. between 2016 and 2020: query of the premier health-care database. Surg Neurol Int 2022;13:364.
5
El Rahal A, Beck J, Ahlborn P, et al. Incidence, therapy, and outcome in the management of chronic subdural hematoma in Switzerland: a population-based multicenter cohort study. Front Neurol 2023;14:1206996.
6
Maroufi SF, Farahbakhsh F, Macdonald RL, et al. Risk factors for recurrence of chronic subdural hematoma after surgical evacuation: a systematic review and meta-analysis. Neurosurg Rev 2023;46:270.
7
Levitt, M. R., Hirsch, J. A., & Chen, M. (2024). Middle meningeal artery embolization for chronic subdural hematoma: an effective treatment with a bright future. Journal of neurointerventional surgery, 16(4), 329–330. https://doi.org/10.1136/jnis-2024-021602