{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:26:18Z","timestamp":1786980378254,"version":"build-2736575974"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T00:00:00Z","timestamp":1685318400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T00:00:00Z","timestamp":1685318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011852","name":"Paracelsus Medical University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011852","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite multiple studies on the embolization of the middle meningeal artery, there is limited data on the treatment response of recurrent chronic subdural hematomas (CSDH) to embolization and on the volume change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively compared the treatment response and volume change of recurrent CSDHs in a conventional group (second surgery) with an embolization group (embolization as stand-alone treatment) during the time-period from August 2019 until June 2022. Different clinical and radiological factors were assessed. Treatment failure was defined as necessity of treatment for second recurrence. Hematoma volumes were determined in the initial CT scan before first surgery, after the first surgery, before retreatment as well as in an early (1\u00a0day\u20132\u00a0weeks) and in a late follow-up CT scan (2\u20138\u00a0weeks).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty recurrent hematomas after initial surgery were treated either by second surgery (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927) or by embolization (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923). 8\/27 (26,6%) surgically treated and 3\/23 (13%) of the hematomas treated by embolization needed to be treated again. This leads to an efficacy in recurrent hematomas of 73,4% in surgically treated and of 87% in embolized hematomas (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.189). In the conventional group, mean volume decreased significantly already in the first follow-up CT scan from 101.7\u00a0ml (SD 53.7) to 60.7\u00a0ml (SD 40.3) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and dropped further in the later follow-up scan to 46.6\u00a0ml (SD 37.1) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). In the embolization group, the mean volume did decrease insignificantly from 75.1\u00a0ml (SD 27.3) to 68\u00a0ml (SD 31.4) in the first scan (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.062). However, in the late scan significant volume reduction to 30.8\u00a0ml (SD 17.1) could be observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Embolization of the middle meningeal artery is an effective treatment option for recurrent CSDH. Patients with mild symptoms who can tolerate slow volume reduction are suitable for embolization, whereas patients with severe symptoms should be reserved for surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-023-05621-7","type":"journal-article","created":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T08:02:18Z","timestamp":1685347338000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Embolization of the middle meningeal artery vs. second surgery\u2014treatment response and volume course of recurrent chronic subdural hematomas"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4798-3369","authenticated-orcid":false,"given":"Adrian","family":"Liebert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Voit-H\u00f6hne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Ritter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Eibl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"St\u00e4dt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Eff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Holtmannsp\u00f6tter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Herbert","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,29]]},"reference":[{"key":"5621_CR1","doi-asserted-by":"publisher","unstructured":"Adusumilli G, Ghozy S, Kallmes KM, et al (2022) Common data elements reported on middle meningeal artery embolization in chronic subdural hematoma: an interactive systematic review of recent trials. 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No additional data was collected. The study was approved by the Institutional Review Board (IRB2021039).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Markus Holtmannsp\u00f6tter received speaker fees from Microvention, Cerenovus, Stryker and Phenox.Heinz Voit-H\u00f6hne received speaker fees from Phenox.Thomas Eibl received research grants from \u201cVerein zur F\u00f6rderung des Tumorzentrums der Universit\u00e4t Erlangen-N\u00fcrnberg.\u201c","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}