Microstructure of embolized capsule of chronic subdural hematoma

BACKGROUND: Chronic subdural hematomas (cSDHs) are frequent and potentially life-threatening neurosurgical conditions affecting, first of all, elderly. Few treatment options are available ranging from observation to removal thought large craniotomy. However, currently, there is tendency to minimize surgical aggression, especially considering poor general condition of elderly patients. Thus, one of gaining popularity method of neurointerventional treatment of cSDHs is medial meningeal artery (MMA) embolization. To date, large series of cases published describing favorable outcomes of this treatment approach. At the same time, few reports are available that describe microstructural changes in cSDH’s capsule after embolization; meanwhile, no exact effect of embolization on pathophysiology of hematoma was determined. CASE DESCRIPTION: Through current paper, we present two cases of cSDH that has previously undergone embolization of MMA, after which cSDHs have been operated through minicraniotomy due to complications after artery embolization. Microstructural changes of hematoma’s capsule are described and discussed. CONCLUSION: Histological changes in embolized capsule suggest embolization of MMA as a valuable method for treatment of cSDHs.