Features of MR angiography of the middle meningeal artery in chronic subdural hematoma and its relationship with prognosis: clinical report of 41 cases

Abstract

Objective To determine the vascular diameter of middle meningeal artery (MMA) in patients with chronic subdural hematoma (CSDH) by magnetic resonance angiography (MRA), and investigate its relationship with patient's prognosis. Methods Clinical data of 41 CSDH patients admitted to our hospital from May 2014 to May 2021 were retrospectively collected and analyzed in this retrospective matched control study. The MMA diameter was obtained by 3D time-of-flight (3D TOF) MRA, and the results of CSDH patients were compared with those of matched healthy controls. After burr hole and drainage, the MMA diameters on the recurrent side were compared with those on the non-recurrent side. Results Among the 41 CSDH patients, the 56 MMA diameters on CSDH side were significantly larger than the 26 MMA diameters on non-CSDH side (P < 0.01), and were larger than the 82 MMA diameters in 41 matched healthy subjects (P < 0.01). In addition, the MMA diameter on non-CSDH side of the 41 CSDH patients was also larger than that in healthy subjects (P < 0.01). There was no significant difference in MMA diameter between the CSDH side with larger bleeding amount and the CSDH side with less in the 11 bilateral CSDH patients (P=0.18). After burr hole and drainage, the 12 MMA diameters in 9 recurrent cases were significantly larger than the 18 MMA diameters in 14 non-recurrent cases (P < 0.01). Conclusion In CSDH patients, the MMA on the CSDH side is significantly thickened, and it on the recurrent side is more obvious than that on the non-recurrent side after burr hole and drainage, suggesting that MMA diameter might be associated with the occurrence and development of CSDH and the prognosis of patients.

Keywords

• chronic subdural hematoma
• middle meningeal artery
• magnetic resonance angiography
• interventional embolization
• prognosis