Insights in Neurosurgery

Middle Meningeal Artery Embolization as a Treatment for Chronic Subdural Hematomas: A Literature Review

Background and objective: This is a literature review aiming to provide an update about the recent findings related to efficacy of MMA embolization in the treatment of chronic subdural hematomas, comparison with conventional therapy and deduction of the current recommendations and indications.

Subjects and methods: The literature is reviewed using a search through the PubMed index using keywords. Studies are then screening, skimmed and thoroughly read. 32 studies ultimately fulfilled the inclusion criteria and are included.

Results: Five indications as for the application of MMAE are deducted from the literature. The usage for as a preventive measure after surgical treatment of symptomatic cSDHs in patients with high risk of recurrence and the usage as a standalone procedure have 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: Safety of MMAE as a procedure is regarded as a general theme through the literature and can be considered for future application. Usage of this procedure in clinical trials with more patient segregation and time frame assessment relative to surgical intervention are recommendations of this literature review.

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