Middle Meningeal Artery Embolization (MMAE) Outcomes for Chronic Subdural Hematoma (cSDH)

Chronic subdural hematoma (cSDH) is a prevalent neurosurgical condition marked by the accumulation of blood in the subarachnoid space. Primarily affecting elderly individuals, cSDH is associated with significant morbidity and mortality rates. Current standard treatments for cSDH involve surgical evacuation through burr hole craniotomy or twist-drill craniotomy; however, recent research has illuminated the potential significance of the middle meningeal artery (MMA) in cSDH pathogenesis, suggesting an innovative minimally invasive treatment avenue. The investigator team is attempting to determine whether MMA embolization has demonstrated a favorable safety profile with a low incidence of treatment-related complications. While traditional surgical interventions have demonstrated positive outcomes in cSDH management, inherent challenges such as perioperative complications, extended hospital stays, and the risk of recurrence persist. Given the emerging insights into cSDH's underlying mechanisms, targeting the MMA presents an intriguing therapeutic alternative. The MMA, which supplies the dura mater's outer layer, has been implicated in cSDH formation and progression due to its fragility and propensity to rupture. By embolization of the MMA (MMAE), the opportunity arises to potentially mitigate bleeding risk and reduce the likelihood of hematoma reaccumulation. Recent case reports and a significant number of retrospective studies have shown encouraging results with MMA embolization as an adjunct or alternative to conventional surgical methods. Nevertheless, most of the reported studies are case series with limited sample sizes. Moreover, a comprehensive assessment of outcomes, complications, and long-term efficacy necessitates well-structured retrospective studies. The findings of this study hold the potential to better understand the outcomes of MMAE for cSDH. This study aims to provide valuable insights that can guide clinical decision-making, potentially leading to improved patient outcomes and more efficient resource utilization, The following collaborators are also involved in the research: Hamza Adel Salim Email: HASalim@MDAnderson.org Adam A Dmytriw MD MPH MSc Email: adam.dmytriw@gmail.com Rahim Abo Kasem, MD Email: rahim.abokasem@louisville.edu Name: Muhammed Amir Essibayi, MD Email: m.amir.essibayi@gmail.com