PMC9699886_01
Head computed tomography (CT) scans of patient 1 after MMA embolization. (a) Axial plane, level of lateral ventricles; (b) axial plane, level of centrum semiovale. Note large right-sided cSDH with enhanced capsule (arrows).
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F1
Postoperative CT scans revealed X-ray density enhancement of cSDH's capsule [Figure 1].
Histological examination of patient's 1 cSDH capsule. (a) Outer (arrow) and inner (dashed arrow) cSDH's capsule membranes, (b) embolized vessels (dashed circle), and (c) embolized vessels of the outer membrane (arrows).
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F2
PMC9699886_02
Initial MRI scans of patient 2. (a and b) T2 MRI, axial plane, (c) T2 MRI, coronal plane. Massive cSDH presented with slight compression on the left hemisphere.
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F3
Neurologist on duty suspected stroke; thus, MRI scan had been performed that reveled massive left-sided cSDH [Figure 3].
Selective angiography of patient 2. (a) Digital subtraction angiography, catheter in MMA, sagittal plane, capsule of cSDH highlighted by red dashed line, (b) digital subtraction angiography, coronal plane, (c and d) color reconstructions of angiograms, sagittal, and coronal plane, respectively.
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F4
Postoperative CT scans of patient 2, axial planes. (a) Embolized capsule highlighted by red arrows, (b and c) clusters of nBCA inside cSDH's capsule.
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F5
CT scans revealed satisfactory pervasion of cSDH's capsule by nBCA with several prominent clusters [Figure 5].
Histological examination of cSDH's capsule stained with hematoxylin and eosin. A - cross section of embolized dural vessel (gray arrow). (b) Longitudinal section of embolized dural vessel, nBCA fragments (gray arrow) and clumped red blood cells (dashed circle). (c and d) nBCA within dural vessels (dashed circles).
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F6
Surgery was uneventful, small piece of hematoma capsule with cluster of nBCA according to the previous CT scans was incised and histologically examined [Figure 6].