Middle Meningeal Embolization for Subdural Hematoma

Chronic subdural hematomas (cSDHs) are one of the most common neurosurgical conditions requiring intervention. Though traditionally managed by surgical methods for hematoma evacuation such as burr-hole drainage or craniotomy, cSDHs frequently recur and require repeated surgical intervention. In recent years, middle meningeal artery (MMA) embolization has been proposed to be an efficacious adjunctive or alternative treatment for cSDHs. We review the role of MMA embolization in the context of the epidemiology, pathophysiology, and presentation of cSDH. In addition, we present and discuss findings from recently published series supporting MMA embolization as a minimally invasive method to treat cSDH. Finally, we discuss the embolization procedure as well as its risks, possible complications, and contraindications.