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Case Reports
. 2021 Jul 6:12:322.
doi: 10.25259/SNI_939_2020. eCollection 2021.

Traumatic epidural hematoma treated with endovascular coil embolization

Michael T Madison  1 , Patrick C Graupman  2 , Jason M Carroll  1 , Collin M Torok  1 , Jillienne C Touchette  3 , Eric S Nussbaum  4
Affiliations
Case Reports

Traumatic epidural hematoma treated with endovascular coil embolization

Michael T Madison et al. Surg Neurol Int. .

Abstract

Background: Traumatic cerebrovascular injury may result in epidural hematoma (EDH) from laceration of the middle meningeal artery (MMA), which is a potentially life-threatening emergency. Treatment ranges from surgical evacuation to conservative management based on a variety of clinical and imaging factors.

Case description: A 14-year-old male presented to our institution after falling from his bicycle with traumatic subarachnoid hemorrhage and a right frontotemporal EDH. The patient did not meet criteria for surgical evacuation and endovascular embolization of the right MMA was performed. Rapid resolution of the EDH was observed.

Conclusion: This case corroborates the sparse existing literature for the potential role of endovascular embolization to treat acute EDH in carefully selected patients who do not meet or have borderline indications for surgical management.

Keywords: Endovascular procedures; Epidural hematoma; Meningeal arteries; Traumatic cerebral hematoma; Traumatic subarachnoid hemorrhage.

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Conflict of interest statement

Jillienne C Touchette is CEO and has ownership interest in Superior Medical Experts.

Figures

Figure 1:
Figure 1:
Preembolization coronal plane reformatted CT image demonstrating a small epidural hematoma over the right hemispheric convexity.
Figure 2:
Figure 2:
Frontal (left) and lateral (right) microangiography of the right MMA without evidence of pseudoaneurysm or active extravasation.
Figure 3:
Figure 3:
ECA angiography, lateral view, demonstrating coil occlusion of the MMA proximal trunk.
Figure 4:
Figure 4:
Postembolization coronal plane reformatted CT image postprocedure day 1 demonstrating markedly decreased size of the hematoma.
See this image and copyright information in PMC

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