Subdural hematoma (SDH) is a well-recognized complication in patients on antiplatelet therapy, particularly in the elderly or those with prior cardiovascular interventions. We report the case of a 63-year-old male with a recent history of percutaneous transluminal coronary angioplasty on dual antiplatelet therapy who presented with a subacute SDH. He underwent burr hole evacuation with symptomatic relief. Postoperatively, blood thinners were restarted after cardiology consultation. However, the patient developed recurrent SDH which was subsequently managed with middle meningeal artery (MMA) embolization. This case highlights the role of MMA embolization in recurrent SDH and the complexity of balancing antiplatelet therapy in neurosurgical patients.
Randhawa et al. (Tue,) studied this question.