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Radiological Outcome of Middle Meningeal Artery Embolization in Relation to Chronic Subdural Hematoma Cause and

Ahmed Abdelghafar1, Andrew Falzon2, Eef J Hendriks1,3

  • 1Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, ON M5T 2S8, Canada.

Brain Sciences
|November 27, 2024
PubMed

Insights

Middle meningeal artery embolization (MMAE) effectively treats chronic subdural hematoma (cSDH) regardless of cause or architecture. Both thickness and volume are reliable measures for assessing MMAE treatment outcomes in cSDH patients.

Area of Science:

  • Neurology
  • Interventional Radiology
  • Neurosurgery

Background:

  • Chronic subdural hematoma (cSDH) poses a significant clinical challenge.
  • Middle meningeal artery embolization (MMAE) is an emerging endovascular treatment for cSDH.
  • Understanding MMAE efficacy based on cSDH characteristics is crucial for treatment optimization.

Purpose of the Study:

  • To evaluate the efficiency of MMAE in treating cSDH.
  • To explore MMAE's effectiveness concerning cSDH cause (spontaneous vs. traumatic) and architecture (mature vs. non-mature).
  • To compare the utility of cSDH thickness and volume in assessing treatment outcomes before and after MMAE.

Main Methods:

  • Retrospective cohort study of 52 consecutive cSDH patients treated with MMAE.
  • Patients were grouped by cSDH cause and architecture.
  • Radiological outcomes (thickness and volume) were assessed using CT imaging pre- and post-MMAE.

Main Results:

  • A significant positive linear correlation was observed between cSDH thickness and volume throughout follow-up.
  • MMAE led to statistically significant reductions in cSDH thickness and volume across most groups.
  • No significant differences in MMAE treatment efficacy were found between spontaneous/traumatic or mature/non-mature cSDH groups.

Conclusions:

  • MMAE demonstrates comparable efficacy for various cSDH types, including spontaneous, traumatic, mature, and non-mature.
  • Spontaneous cSDH showed a slight advantage over traumatic cSDH at 6-12 months follow-up.
  • Long-term follow-up may be beneficial for traumatic cSDH post-MMAE.
  • cSDH thickness and volume are reliable and similar parameters for evaluating MMAE treatment response.

Keywords:
chronic subdural hematomachronic subdural hematoma architecturechronic subdural hematoma causemiddle meningeal artery embolization

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