Middle meningeal artery embolisation: The review of a new treatment for chronic subdural hematomas

Abstract

Background: This is a literature review aiming to provide an update about the recent findings related to the efficacy of middle meningeal artery embolization (MMAE) in the treatment of chronic subdural hematomas (cSDHs), comparison with conventional therapy and deduction of the current recommendations and indications. Methods: The literature is reviewed using a search through the PubMed index using keywords. Studies are then screened, skimmed, and thoroughly read. 32 studies fulfilled the inclusion criteria and are included in the study. Results: Five indications for the application of MMA embolization (MMAE) are deducted from the literature. The usage as a preventive measure after surgical treatment of symptomatic cSDHs in patients with a high risk of recurrence and the usage as a standalone procedure has been the most common reasons for indication of this procedure. Rates of failures for the aforementioned indications have been 6.8% and 3.8%, respectively. Conclusion: The safety of MMAE as a procedure is regarded as a general theme in the literature and can be considered for future applications. Usage of this procedure in clinical trials with more patient segregation and timeframe assessment relative to surgical intervention are recommendations of this literature review.

Single Pterional Burr Hole Coupled with Coagulation of the Middle Meningeal Artery for Management of a Chronic Subdural Hematoma in a 98-Year-Old Patient: Illustrative Case

“…Although several recent studies have explored the relative safety and efficacy of MMAE vs burr hole drainage, none of those studies has reached level I scientific rigor. Indeed, there are several ongoing multi-center, prospective, randomized studies being conducted to address the role of efficacy of MMAE [ 19 , 20 ].…”

How artificial intelligence can provide information about subdural hematoma: Assessment of readability, reliability, and quality of ChatGPT, BARD, and perplexity responses

“…[4][5][6][7][8] It has been reported that increase in antithrombotic use, aging of the population, alcoholism, neurological and systemic diseases due to brain atrophy, hemodialysis, low intracranial pressure and dural rupture associated with an increased risk of SDH. [5,8] The clinical presentation of SDH is highly variable. Patients typically present with confusion, headache, and loss of consciousness.…”

“…SDH appears as a crescent-shaped mass with a hypodense to isodense consistency on cranial computed tomography. [5][6][7][8][9][10] Treatment for SDH can be conservative or surgical, depending on symptoms and clot size. Complications and relapses are reported to be common.…”

“…Compared to past studies, its incidence is increasing over the years. [ 4 – 8 ] It has been reported that increase in antithrombotic use, aging of the population, alcoholism, neurological and systemic diseases due to brain atrophy, hemodialysis, low intracranial pressure and dural rupture associated with an increased risk of SDH. [ 5 , 8 ] The clinical presentation of SDH is highly variable.…”

Revolutionizing Treatment for Chronic Subdural Hematoma: Promising Outcomes With Middle Meningeal Artery Embolization

“…The researchers involved in this prospective case series hypothesized about the results of MMAE and the findings associated with its application. This study aims to evaluate the use of MMAE, drawing on an algorithm devised from previous and recent systematic reviews of MMAE for the treatment of cSDHs [ 11 ].…”