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Background: Endovascular embolization of intracranial meningiomas is commonly performed as an adjunct to surgical resection and may reduce intraoperative blood loss and surgical time. However, it remains unclear whether preoperative embolization improves the surgical outcomes of meningioma patients. Objectives: This study aimed to assess the safety and efficacy of preoperative embolization in patients with giant intracranial meningiomas. Methods: This retrospective cohort study included patients diagnosed with cranial meningiomas who underwent surgical treatment. The population group was subdivided into 2 categories: Surgery alone and preoperative meningioma embolization. Outcome variables included the degree of devascularization, intraprocedural complications, intraoperative complications, intraoperative blood loss, surgical time, postoperative complications, and the necessity of blood transfusions. Results: In this study, a total of 189 patients with meningiomas were enrolled. Among them, 22 patients underwent preoperative tumor embolization. The tumor volume was significantly larger in the combined treatment group compared to the surgery-alone group (P = 0.002). Additionally, there was a significant difference in tumor location between the groups (P < 0.001), with more meningiomas being situated deeper in the combined group. In the subgroup analysis of giant meningiomas, intraoperative blood loss was significantly lower in embolized patients compared to non-embolized patients (P = 0.034), while no difference in surgical time was observed (P = 0.570). Conclusions: Preoperative embolization in appropriately selected patients with giant intracranial meningiomas, especially those in deeper locations, was safe and feasible, showing a substantial degree of tumor devascularization with an acceptably low rate of complications. This may have had a positive effect on intraoperative blood loss and the duration of surgery. [ABSTRACT FROM AUTHOR]

Background Chronic subdural hematoma (CSDH) is a common neurosurgical condition with high recurrence rates. Repeated microbleedings from fragile neo-vessels supplied by peripheral branches of the middle meningeal artery (MMA) are believed to be responsible for the growth and recurrence of CSDH. Thus, MMA embolization might be a promising method to prevent re-bleedings and recurrences. This study aims to assess the efficacy, complication rates, and mid-term outcome of MMA embolization with or without burr hole irrigation compared with burr hole irrigation alone. Methods Patients diagnosed with CSDH who underwent MMA embolization and/or surgical treatment were retrospectively recruited to this single-center study. The outcome variables were defined as treatment-related complications, clinical outcome at discharge, rate of revision surgery, and CT findings during the follow-up period. Results A total of 132 patients with CSDH were included in the study. The use of antiplatelet/ anticoagulant medication was significantly higher in the combined treatment and embolization group (p<0.001). A trend towards fewer revision surgeries was found in the group of patients who received MMA embolization combined with burr hole irrigation (p=0.083). Follow-up was available for 73 patients (55.3%) with a mean follow-up period of 3.4±2.2 months. Eight patients (15.1%) of the surgery group showed hematoma re-accumulation and needed surgical rescue, whereas only one patient (5.0%) of the combined treatment group needed revision surgery. In all patients treated with only MMA embolization, complete hematoma resolution was found. Conclusion MMA embolization is a safe and efficacious minimal invasive adjuvant and/or alternative procedure for the treatment of CSDH with a reduced recurrence rate. [ABSTRACT FROM AUTHOR]