{
  "abstract": "Introduction Treatment of chronic subdural hematoma (cSDH) is challenging, because of high recurrence rates. Surgery is mainstay but embolization of middle meningeal artery has shown effectiveness and provides an emerging treatment option. Although CT is standard, MRI has been suggested for further characterization of treatment-naïve hematoma. Studies revealed inter- and intra-hematoma heterogeneity and proposed surrogates for recurrent bleeding, like T1-hyperintensity. However, MRI data of post-treatment cSDH is scarce.Aim of Study Therefore, we sought to analyze the appearance of post-treament cSDH by MRI within a prospective cohort study and to examine differences between treatment.Method We performed 1.5T MRI in 79 patients within 300 days post-treatment. Patients underwent surgery (n=64), embolization (n=2) or both (n=12). As 25 patients had bilateral hematoma, we analyzed 104 hematomas. Size, patterns and MRI signal was evaluated.Results Residual hematoma was detected in 79% and mean diameter was 4,7 millimetres. There was a tendency towards lower diameter after surgery and embolization vs. surgery alone (3.7 vs. 5.1mm; p=0.22; t-test). Appearance was heterogenous and most hematomas showed mixed patterns. Regarding detection and volumetry of T1-hyperintense components, there was no significant difference between embolization vs. surgery (7.69% vs. 14.1%; p=0.51; Fisher´s test. 2.99cm 3 vs. 5.56cm3; p=0.56; t-test).Conclusion MRI allows detection of small residual hematomas that were frequent in our cohort. In line with pre-treatment cSDH, appearance was heterogenous. No statistically significant treatment-related difference was seen but sample sizes were unbalanced. Hence, more patients after embolization are needed to examine possible MRI-features of post-treatment cSDH.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Neuroradiology Section, BKH Günzburg, Department of Radiology, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Johannes Steinhart"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, BKH Günzburg, Department of Neurosurgery, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Sheri Tuzi"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, BKH Günzburg, Department of Neurosurgery, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Nadja Grübel"
    },
    {
      "affiliations": [
        "Neuroradiology Section, BKH Günzburg, Department of Radiology, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Till Malzacher"
    },
    {
      "affiliations": [
        "Neuroradiology Section, BKH Günzburg, Department of Radiology, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Michael Braun"
    },
    {
      "affiliations": [
        "Neuroradiology Section, BKH Günzburg, Department of Radiology, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Bernd Schmitz"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, BKH Günzburg, Department of Neurosurgery, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Andrej Pala"
    },
    {
      "affiliations": [
        "Neuroradiology Section, BKH Günzburg, Department of Radiology, Ulm University Hospital, Günzburg, Germany"
      ],
      "name": "Johannes Rosskopf"
    }
  ],
  "title": "A298 MRI study of post-treatment chronic subdural hematoma after surgical evacuation and middle mengingeal artery embolization within a prospective cohort study",
  "uid": "4265ea0c-e4c9-5084-8b79-a6bdd11df7cc"
}