Middle meningeal artery embolization for chronic subdural hematoma

Chronic subdural hematoma (cSDH) is a prevalent disease with increasing incidence and financial burden to the health-care system. Middle meningeal artery embolization (MMAE) has emerged over the last decade as a minimally invasive treatment for cSDHs, either as an adjunct to surgery or as a standalone therapy in select cases where patients are poor surgical candidates. Although a relatively safe procedure, careful anatomic consideration must be made prior to embolization to decrease risk of unintentional embolization and cranial nerve injury. To date, many case series have been published that demonstrated efficacy and safety of MMAE. Multiple randomized control trials are underway comparing MMAE to conventional management either as an adjunct or standalone treat ment.