Best practice in the use of middle meningeal artery embolisation for chronic subdural haematoma.
Chronic subdural haematoma (cSDH) is a common neurosurgical disorder in older people and projected to become the most common cranial neurosurgical pathology by 2030. Incidence of cSDH has risen in recent years as a consequence of improved access to brain imaging, and the increased prescribing of ant...
| Publicado en: | Age & Ageing Vol. 54; no. 3; pp. 1 - 8 |
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| Autores principales: | , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Mar2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=184349365&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 184349365 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Mar2025 vid: 54 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 184349365 10.1093/ageing/afaf054 ppf: 1 ppct: 7 formats: tig: atl: Best practice in the use of middle meningeal artery embolisation for chronic subdural haematoma. aug: au: Rickard, Frances Backhouse, Mark Langberg, Alexandra Mortimer, Alex Willliams, Adam Cox, Anthony Wigfield, Crispin Shipway, David affil: Geriatric Medicine, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK Interventional Neuroradiology, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK Neurosurgery, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, UK University of Bristol, Faculty of Health and Life Sciences, Bristol, BS8 1UD, UK su: Memory Chronic disease treatment Chronic disease diagnosis Therapeutic embolization Computed tomography Headache Aspirin Clopidogrel Subdural hematoma Meningeal artery Accidental falls sug: subj: Memory Pharmaceutical and medicine manufacturing Medicinal and Botanical Manufacturing Irradiation Apparatus Manufacturing Chronic disease treatment Chronic disease diagnosis Therapeutic embolization Computed tomography Headache Aspirin Clopidogrel Subdural hematoma Meningeal artery Accidental falls keyword: best practice burr hole procedure chronic chronic subdural haematoma embolization frailty hematoma meningeal arteries middle meningeal artery embolisation neurosurgery neurosurgery specialty neurosurgical procedures older adult older adults older people randomization subdural best practice burr hole procedure chronic chronic subdural haematoma embolization frailty hematoma meningeal arteries middle meningeal artery embolisation neurosurgery neurosurgery specialty neurosurgical procedures older adult older adults older people randomization subdural ab: Chronic subdural haematoma (cSDH) is a common neurosurgical disorder in older people and projected to become the most common cranial neurosurgical pathology by 2030. Incidence of cSDH has risen in recent years as a consequence of improved access to brain imaging, and the increased prescribing of antithrombotic medication for both primary and secondary prevention of vascular disease. Chronic SDH typically presents with an insidious onset of broad-ranging symptoms including impaired cognition, gait, balance and mobility, often with headache. It progresses to more fulminant symptoms of hemiplegia, dysphasia and eventually coma. Although the established standard of care for clearly symptomatic cSDH is burr hole trephination, Middle Meningeal Artery Embolisation (MMAE) has emerged as a minimally invasive treatment option for some patients with cSDH. This is a rapidly evolving field: recently published randomised control trials have provided an evidence-base supporting the use of MMAE not only as an adjunct to burr hole trephination, but also in patients in whom trephination is contraindicated, or in patients with mild symptomatology who are not considered appropriate for immediate burr hole trephination. This article provides practical, real-world guidance on current best practice based on our experience and the published evidence available to date. We use case studies and treatment algorithms from the UK's highest volume MMAE centre to illustrate collaborative care pathways for patients with cSDH between neurosurgery, interventional neuroradiology and trauma geriatricians. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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