Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case report

Chronic subdural hematoma is a common condition in neurosurgical practice. It is usually treated by burr-hole surgery. Patients with coagulopathies such as antiphospholipid syndrome, are at increased risk of complications, and careful consideration of the patient’s specific risk of both bleeding and...

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Main Authors: Kristoffer Ambeck Aagaard, Halldór Bjarki Einarsson, Hans Værum Gram Novrup
Format: Article
Language:English
Published: SAGE Publishing 2025-01-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251315032
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author Kristoffer Ambeck Aagaard
Halldór Bjarki Einarsson
Hans Værum Gram Novrup
author_facet Kristoffer Ambeck Aagaard
Halldór Bjarki Einarsson
Hans Værum Gram Novrup
author_sort Kristoffer Ambeck Aagaard
collection DOAJ
description Chronic subdural hematoma is a common condition in neurosurgical practice. It is usually treated by burr-hole surgery. Patients with coagulopathies such as antiphospholipid syndrome, are at increased risk of complications, and careful consideration of the patient’s specific risk of both bleeding and thromboembolic complications must guide medical management. We present the case of a 34-year-old who presented to the neurosurgical department with a chronic subdural hematoma. She had a medical history of triple-positive antiphospholipid syndrome, lupus, and mechanical aortic valve replacement due to Libman-Sacks endocarditis. It was considered of high risk to proceed with traditional burr-hole surgery, so instead embolization of the middle meningeal artery was performed. Postoperatively the patient gradually improved, and a scan at 6 months showed complete regression of the hematoma. She later presented with a contralateral subdural hematoma, which was also successfully treated with middle meningeal artery embolization. Unfortunately, she suffered from an intracerebral hemorrhage shortly afterward, which was treated conservatively by careful management of her anticoagulant therapy. She has now made a full recovery at 4 months follow-up.
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spelling doaj-art-6dba5044ec12414f96e9e15d9078ee7b2025-01-29T11:04:34ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-01-011310.1177/2050313X251315032Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case reportKristoffer Ambeck Aagaard0Halldór Bjarki Einarsson1Hans Værum Gram Novrup2Department of Neurosurgery, Aalborg University Hospital, Aalborg, DenmarkDepartment of Neurosurgery, Aalborg University Hospital, Aalborg, DenmarkDepartment of Neuroradiology, Aalborg University Hospital, Aalborg, DenmarkChronic subdural hematoma is a common condition in neurosurgical practice. It is usually treated by burr-hole surgery. Patients with coagulopathies such as antiphospholipid syndrome, are at increased risk of complications, and careful consideration of the patient’s specific risk of both bleeding and thromboembolic complications must guide medical management. We present the case of a 34-year-old who presented to the neurosurgical department with a chronic subdural hematoma. She had a medical history of triple-positive antiphospholipid syndrome, lupus, and mechanical aortic valve replacement due to Libman-Sacks endocarditis. It was considered of high risk to proceed with traditional burr-hole surgery, so instead embolization of the middle meningeal artery was performed. Postoperatively the patient gradually improved, and a scan at 6 months showed complete regression of the hematoma. She later presented with a contralateral subdural hematoma, which was also successfully treated with middle meningeal artery embolization. Unfortunately, she suffered from an intracerebral hemorrhage shortly afterward, which was treated conservatively by careful management of her anticoagulant therapy. She has now made a full recovery at 4 months follow-up.https://doi.org/10.1177/2050313X251315032
spellingShingle Kristoffer Ambeck Aagaard
Halldór Bjarki Einarsson
Hans Værum Gram Novrup
Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case report
SAGE Open Medical Case Reports
title Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case report
title_full Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case report
title_fullStr Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case report
title_full_unstemmed Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case report
title_short Middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome: A case report
title_sort middle meningeal artery embolization for chronic subdural hematoma in a young patient with antiphospholipid syndrome a case report
url https://doi.org/10.1177/2050313X251315032
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