Related Experiment Video

Updated: May 8, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
10:34

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage

Published on: August 30, 2020

Embolization of the Middle Meningeal Artery in Chronic Subdural Hematomas

Arwed E Michael1, Daniel Behme2, Omid Nikoubashman3

  • 1University Medical Center of the Johannes Gutenberg University Mainz Department of Neuroradiology, Department of Neuroradiology, RP, Germany, Mainz.

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|May 6, 2026
PubMed

Middle meningeal artery embolization (MMAE) is a relatively new option for treating chronic subdural hematoma (CSDH). First used in the year 2000 in patients with CSDH and pronounced coagulopathy, today there are several large randomized controlled trials available that report on the efficacy of MMAE. Based on a complex pathophysiological model of CSDH with a focus on inflammation, fibrinolysis, and neoangiogenesis, the MMAE procedure works by blocking the pathological vessels of the CSDH membranes, whose activity prevents resorption of a CSDH. Embolization of the middle meningeal artery requires precise knowledge of the individual anatomy, as severe adverse effects can result from misembolization in critical collaterals. In principle, particles, liquid embolic agents, and coils are available as embolic agents, although particles and liquid embolic agents have been used in the randomized controlled trials published so far. Based on the latest large trials, MMAE is currently recommended by interdisciplinary consensus for patients with de novo CSDH and contraindications to surgical therapy, as well as for patients with recurrence as an adjunct to conventional therapy. Numerous other trials on MMAE have already been registered, so additional data regarding previously unanswered questions are expected in the near future.

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