Is Embolization a Safe Treatment Option for Certain Traumatic Subdural Hematomas?

Area of Science:

• Neurosurgery
• Interventional Radiology
• Trauma Care

Background:

• Middle meningeal artery (MMA) embolization is established for chronic subdural hematoma (SDH).
• The safety and efficacy of MMA embolization in acute SDH are not well-defined.
• This study investigates MMA embolization for acute SDH management.

Purpose of the Study:

• To evaluate the safety of MMA embolization in patients with acute subdural hematoma.
• To compare outcomes between patients with acute SDH who underwent MMA embolization and those who did not.

Main Methods:

• Retrospective review of 33 adult acute SDH patients treated between July 2021 and July 2023.
• Comparison of demographics, injury characteristics, treatments, and outcomes between embolized (n=17) and non-embolized (n=16) groups.
• Analysis included patients with acute bleeding and acute-on-chronic bleeding.

Main Results:

• The MMA embolization group was older (median 71.0 vs. 37.5 years) and had higher median Glasgow Coma Scale (GCS) scores (14.0 vs. 11.5).
• No patients required craniotomy after MMA embolization.
• One patient managed non-operatively after embolization underwent burr hole evacuation and was discharged.

Conclusions:

• MMA embolization appears safe and potentially effective as an adjunct for acute SDH management.
• The procedure may be particularly beneficial in less severe acute SDH cases.
• Further large-scale, controlled studies are necessary to confirm its role in standard treatment protocols.