A Case of Acute Epidural Hematoma Successfully Treated with Middle Meningeal Artery Embolization

We report a case of acute epidural hematoma (AEDH) successfully treated with middle meningeal artery (MMA) embolization. A 59-year-old man presented with headache 2 days after minor head trauma. Head computed tomography (CT) revealed a left-sided AEDH with an associated skull fracture. Although the patient had only mild disturbance of consciousness and no focal neurological deficits, the hematoma volume was significant. Given the absence of mass effect and to prevent further hematoma expansion, emergent MMA embolization was performed via a transradial approach under local anesthesia. Angiography demonstrated contrast extravasation from the MMA, which was successfully embolized using 20% n-butyl-2-cyanoacrylate. The patient's postoperative course was uneventful, and the hematoma showed near-complete resolution on follow-up CT 1 month later. This case highlights the potential utility of MMA embolization as a minimally invasive and effective treatment option for select AEDH cases that do not require emergency craniotomy.