Middle Meningeal Artery Embolization for Chronic Subdural Hematoma:A 3-Case Series and Literature Review

Xingguo Xu; Cunxin zhu; Zhenxing Yang; Ji Yin; Xianhao Huo; Dejun Huang

doi:10.71321/dp20z404

Authors

Xingguo Xu Department of Neurosurgery, Ningxia Medical University General Hospital
Cunxin zhu Department of nursing, Qilu Medical University
Zhenxing Yang Department of Neurosurgery, Ningxia Medical University General Hospital
Ji Yin Department of Neurosurgery, Ningxia Medical University General Hospital
Xianhao Huo Department of Neurosurgery, Ningxia Medical University General Hospital
Dejun Huang Department of Neurosurgery, Ningxia Medical University General Hospital

DOI:

https://doi.org/10.71321/dp20z404

Keywords:

MMAE, CSDH, mRS, Case Series

Abstract

Objective: To explore the efficacy of middle meningeal artery embolization (MMAE) in the treatment of chronic subdural hematoma (CSDH).

Methods: We retrospectively analyzed clinical data of 3 patients (with 4-sided hematomas) diagnosed with CSDH who were admitted to the Department of Neurosurgery, General Hospital of Ningxia Medical University in December 2021. Two patients underwent MMAE (one with bilateral MMA embolization), and one patient received MMAE combined with subdural burr hole drainage. All patients were embolized using Onyx glue. Clinical efficacy was evaluated using the modified Rankin Scale (mRS), with a ≥1-point decrease post-treatment defined as symptom improvement. Hematoma absorption was assessed via imaging.

Results: Successful superselective catheterization of the middle meningeal artery (MMA) was achieved in all 3 patients (4-sided hematomas), with complete occlusion of the frontoparietal trunk of the MMA and its main branches. No procedure-related complications occurred. During a 2–4 month follow-up, all patients showed clinical improvement (mRS decreased by 1–2 points). Imaging confirmed complete absorption of all 4-sided hematomas, resolution of clinical symptoms, and no recurrence.

Conclusion: MMAE is a safe, effective, and promising treatment for CSDH.

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