Efficacy of middle meningeal artery embolization in the treatment of refractory chronic subdural hematoma

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Abstract
There are no established treatment procedures for repeatedly recurring chronic subdural hematoma (CSH). In this study, we discussed the efficacy of middle meningeal artery (MMA) embolization in preventing recurrence of CSH. We performed superselective angiography of MMA in four patients who suffered from repeated recurrence of CSH. After angiography, we performed embolization of MMA with endovascular procedure. In all cases, superselective angiography of MMA revealed diffuse abnormal vascular stains that seemed to represent the macrocapillaries in the outer membrane of CSH. In all the patients, there were no recurrences or enlargements of CSH after the embolization of the MMA. MMA embolization can be an effective adjuvant procedure in preventing the recurrence of CSH.

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