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Regarding “Emergency Department Visits for Chronic Subdural Hematomas within 30 Days after Surgical Evacuation with and without Middle Meningeal Artery Embolization”

Regarding “Emergency Department Visits for Chronic Subdural Hematomas within 30 Days after... LETTERS Regarding “Emergency Department Visits for Chronic Subdural Hematomas within 30 Days after Surgical Evacuation with and without Middle Meningeal Artery Embolization” read with great interest the retrospective clinical study by Second, the authors described ED visits and re-admission ICatapano et al on the evaluation of emergency department (ED) within 30 days as the primary outcomes. There were 34 patients visits and re-admission within 30 days for patients with chronic with ED visits and 17 patients with re-admission within 30 days. I subdural hematomas (cSDH) with and without adjunctive middle wonder whether follow-up recurrence of cSDH occurred in these meningeal artery embolization. To address this issue, the aforemen- patients and if these patients had been re-admitted to the hospital tioned authors included 137 patients with cSDH based on the inclu- for any other reasons, which may be a potential source of bias. sion criteria. Patients were divided into 2 groups (the surgery-only In addition, the authors acknowledge the limitations of this group and the combined group) according to the presence or ab- study, including the single-center and retrospective design and all sence of middle meningeal artery embolization. The authors com- the procedures performed by the different operators and different paredthe ED visits andre-admissionwithin 30days for patients surgical teams. Given that limitations are inevitable, even in high- with cSDH between the 2 groups. The results concluded that there quality studies, further large-scale prospective randomized con- were fewer 30-day emergency department visits in the combined trolled studies are required to validate the conclusions from this arti- group compared with the surgery-only group. cle. There are related clinical trials underway to make the current I would like to understand more information about this excel- picture clearer. lent research work and would like to share my personal views according to previously published studies. Disclosure forms provided by the authors are available with the full text and PDF of this article at www.ajnr.org. First, the authors did not disclose the preoperative and postop- erative management of patients between the 2 groups, including REFERENCES anticoagulants or antiplatelet agent therapy and statin use. Statins 1. Catapano JS, Scherschinski L, Rumalla K, et al. Emergency department may reduce inflammatory signaling and promote hematoma visits for chronic subdural hematomas within 30 days after surgical resorption by decreasing the expression of inflammatory mediators evacuation with and without middle meningeal artery embolization. AJNR Am J Neuroradiol 2022;43:1148–51 CrossRef Medline on the hematoma pseudomembrane in patients with cSDH. A pro- 2. Wang D, Tian Y, Wei H, et al. Risk factor analysis of the conservative spective clinical trial on critical independent predictors of the suc- treatment in chronic subdural hematomas: a substudy of the ATOCH cess of atorvastatin monotherapy treatment suggested that higher Trial. Adv Ther 2022;39:1630–41 CrossRef Medline total cholesterol, lower hematoma volume, and less midline shift in atorvastatin monotherapy are independent factors predictive of L. Wang success. Therefore, the authors should uncover the details of post- Department of Neurosurgery Zhongnan Hospital of Wuhan University operative management between the 2 groups. Wuhan, China http://dx.doi.org/10.3174/ajnr.A7654 E2 Letters Jan 2023 www.ajnr.org http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Regarding “Emergency Department Visits for Chronic Subdural Hematomas within 30 Days after Surgical Evacuation with and without Middle Meningeal Artery Embolization”

Wang, L.
American Journal of Neuroradiology , Volume 44 (1): 1 – Jan 1, 2023
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References (2)

Publisher
American Journal of Neuroradiology
Copyright
© 2023 by American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.a7654
Publisher site
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Abstract

LETTERS Regarding “Emergency Department Visits for Chronic Subdural Hematomas within 30 Days after Surgical Evacuation with and without Middle Meningeal Artery Embolization” read with great interest the retrospective clinical study by Second, the authors described ED visits and re-admission ICatapano et al on the evaluation of emergency department (ED) within 30 days as the primary outcomes. There were 34 patients visits and re-admission within 30 days for patients with chronic with ED visits and 17 patients with re-admission within 30 days. I subdural hematomas (cSDH) with and without adjunctive middle wonder whether follow-up recurrence of cSDH occurred in these meningeal artery embolization. To address this issue, the aforemen- patients and if these patients had been re-admitted to the hospital tioned authors included 137 patients with cSDH based on the inclu- for any other reasons, which may be a potential source of bias. sion criteria. Patients were divided into 2 groups (the surgery-only In addition, the authors acknowledge the limitations of this group and the combined group) according to the presence or ab- study, including the single-center and retrospective design and all sence of middle meningeal artery embolization. The authors com- the procedures performed by the different operators and different paredthe ED visits andre-admissionwithin 30days for patients surgical teams. Given that limitations are inevitable, even in high- with cSDH between the 2 groups. The results concluded that there quality studies, further large-scale prospective randomized con- were fewer 30-day emergency department visits in the combined trolled studies are required to validate the conclusions from this arti- group compared with the surgery-only group. cle. There are related clinical trials underway to make the current I would like to understand more information about this excel- picture clearer. lent research work and would like to share my personal views according to previously published studies. Disclosure forms provided by the authors are available with the full text and PDF of this article at www.ajnr.org. First, the authors did not disclose the preoperative and postop- erative management of patients between the 2 groups, including REFERENCES anticoagulants or antiplatelet agent therapy and statin use. Statins 1. Catapano JS, Scherschinski L, Rumalla K, et al. Emergency department may reduce inflammatory signaling and promote hematoma visits for chronic subdural hematomas within 30 days after surgical resorption by decreasing the expression of inflammatory mediators evacuation with and without middle meningeal artery embolization. AJNR Am J Neuroradiol 2022;43:1148–51 CrossRef Medline on the hematoma pseudomembrane in patients with cSDH. A pro- 2. Wang D, Tian Y, Wei H, et al. Risk factor analysis of the conservative spective clinical trial on critical independent predictors of the suc- treatment in chronic subdural hematomas: a substudy of the ATOCH cess of atorvastatin monotherapy treatment suggested that higher Trial. Adv Ther 2022;39:1630–41 CrossRef Medline total cholesterol, lower hematoma volume, and less midline shift in atorvastatin monotherapy are independent factors predictive of L. Wang success. Therefore, the authors should uncover the details of post- Department of Neurosurgery Zhongnan Hospital of Wuhan University operative management between the 2 groups. Wuhan, China http://dx.doi.org/10.3174/ajnr.A7654 E2 Letters Jan 2023 www.ajnr.org

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Jan 1, 2023

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