Is Middle Meningeal Artery Embolization Helpful for Chronic Subdural Hematomas?

Chronic subdural hematoma (SDH) is a frequent cause of disability. Once established, chronic SDHs often expand and, even when treated neurosurgically, frequently recur, requiring repeat operation. Because the subdural vasculature predominantly arises from the middle meningeal artery (MMA), embolization of the MMA might promote SDH reabsorption and reduce the need for initial or repeat surgeries. To test this hypothesis, researchers conducted an open-label, manufacturer-funded, multicenter study of MMA embolization via a nonadherent liquid. Participants had symptomatic chronic SDH >1 cm in maximum thickness. The primary outcome, assessed 180 days after treatment, was a composite of residual or recurrent SDH >1 cm; surgical rescue or repeat o…