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Middle Meningeal Artery (MMA) Embolization for Recurrent Subacute Subdural Hematoma With Complete Resolution
Farid Bouhouf1, Abdullah F Alsubaii2, Khalid A Alshammari3
1Department of Neurosurgery, King Abdulaziz Medical City, Ministry of National Guard Hospital, Riyadh, SAU.
Abstract:
Recurrent subdural hematoma (RSDH) is a condition characterized by repeated blood accumulation beneath the dura mater, which often poses challenges in clinical management. Conventional surgical interventions, such as burr hole irrigation and drainage, are standard treatments but carry a risk of recurrence. Therefore, middle meningeal artery (MMA) embolization has recently emerged as a promising alternative to address RSDH. This case report provides an overview of an RSDH in a 56-year-old female who underwent successful MMA embolization. She initially experienced a worsening of the hematoma with an acute-on-chronic component, which later regressed significantly, leading to near-complete resolution over a one-year follow-up period. Such an outcome has not been well documented in the existing literature and therefore represents an important case study that underscores the potential of MMA embolization as a viable option for RSDH, even in cases of transient post-procedural radiological hematoma expansion. The findings emphasize the importance of careful patient monitoring and suggest that MMA embolization may offer an effective, minimally invasive alternative to surgery in select cases. It also highlights the need for ongoing research to determine the long-term effectiveness and safety of the procedure.

