Evidence map›Paper›PMID 41420704›Full record

ArticleActa neurochirurgica2025

A visual mining analysis of middle meningeal embolization and other factors associated with recurrence requiring re-operation in subdural hematomas: a single-center series.

Marco Battistelli, Marika Vezzoli, Iacopo Valente, Massimo Benenati, Giuseppe Garignano, Andrea Alexandre, Ludovico Agostini, Samuele Santi, Ottavia Giovinazzo, Leonardo Nardini and 12 more

Abstract read
In one paragraph

Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Marco Battistelli *Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Marika Vezzoli *Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
Iacopo ValenteUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Roma, Italy.
Massimo BenenatiDipartimento Di Diagnostica Per Immagini, Radioterapia, Oncologia Ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Giuseppe GarignanoUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Roma, Italy.
Andrea AlexandreUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Roma, Italy.
Ludovico AgostiniNeurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Samuele SantiNeurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Ottavia GiovinazzoUniversità Cattolica del Sacro Cuore, Rome, Italy.
Leonardo NardiniDipartimento Di Diagnostica Per Immagini, Radioterapia, Oncologia Ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Federico CostaDipartimento Di Diagnostica Per Immagini, Radioterapia, Oncologia Ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Giorgio Quintino D'AlessandrisNeurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Manuela D'ErcoleNeurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
Alessandro IzzoNeurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
Alessandro RapisardaNeurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
Francesco SignorelliNeurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
Nicola MontanoNeurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Simona GaudinoDipartimento Di Diagnostica Per Immagini, Radioterapia, Oncologia Ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Alessandro OliviNeurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Alessandro PedicelliUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Roma, Italy.
Filippo Maria PolliNeurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy. filippomaria.polli@policlinicogemelli.it.
Francesco DogliettoNeurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeto comprehensively and hierarchically assess risk factors for recurrence requiring reoperation (RrR) in chronic subdural hematoma (cSDH) in the era of middle meningeal artery embolization (MMAE).

methodsPatients treated for a cSDH from January 2019 to October 2024 at Fondazione Gemelli research hospital were considered for inclusion. Clinical, coagulation, radiological, and treatment factors were recorded. MMAE was performed systematically from October 2022, using polyvinyl alcohol (PVA) particles injected directly from the main trunk of MMA. The dataset comprised 45 quantitative and qualitative variables for each cSDH. Variables showing statistical significance (p-value < 0.05) were selected as covariates in two supervised learning frameworks to predict the RrR (outcome, Y): (i) Classification and Regression Tree (CART) and (ii) Random Forest (RF) classifier.

results500 patients were eligible and 233 were included, resulting in 283 treated cSDHs (mean follow-up: 119 days); 129 underwent adjuvant MMAE. 50 cSDH had a RrR (mean time to recurrence: 47 days), of which 41 (82%) in the non-embolized group and 9 (18%) in the embolized group (p-value < 0.001). Adjuvant embolization was the strongest factor associated with RrR, significantly reducing the risk for reintervention. Markwalder grading scale, preoperative cSDH volume, and platelet count (PLT) are strong predictors in non-embolized patients. A critical PLT cut-off of 229 × 10

conclusionsThe present results support the routine use of MMAE and the correction of PLT in relation to cSDH volume.

Indexed as

Embolization, TherapeuticHematoma, Subdural, ChronicMeningeal ArteriesReoperationAgedAged, 80 and overFemaleHumansMaleMiddle AgedRecurrenceRetrospective StudiesRisk FactorsCase-seriesChronic subdural hematomaMarkwalder grading scaleMiddle meningeal artery embolizationPlatelet countRecurrence requiring reoperation

Identifiers

PMID41420704
PMCPMC12722316

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.