AUTHOR=Omura Yoshihiro , Ishiguro Taichi 

TITLE=Middle meningeal artery embolization for chronic subdural hematoma: a systematic review

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1259647

DOI=10.3389/fneur.2023.1259647

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Background</title><p>Chronic subdural hematoma (cSDH) is one of the most common diseases in neurosurgery. Middle meningeal artery embolization (MMAE) is reportedly an option to prevent recurrence or avoid surgery in patients with cSDH. This study was performed to review the evidence on MMAE for cSDH and evaluate its safety, efficacy, indications, and feasibility.</p></sec><sec id="sec2"><title>Methods</title><p>We systematically reviewed the literature according to the PRISMA guidelines using an electronic database. The search yielded 43 articles involving 2,783 patients who underwent MMAE.</p></sec><sec id="sec3"><title>Results</title><p>The hematoma resolution, recurrence, and retreatment rates in the MMAE-alone treatment group (<italic>n</italic> = 815) were 86.7%, 6.3%, and 9.6%, respectively, whereas those in the prophylactic MMAE with combined surgery group (<italic>n</italic> = 370) were 95.6%, 4.4%, and 3.4%, respectively. The overall MMAE-related complication rate was 2.3%.</p></sec><sec id="sec4"><title>Conclusion</title><p>This study shows that MMAE alone is, although not immediate, as effective as evacuation surgery alone in reducing hematoma. The study also shows that combined treatment has a lower recurrence rate than evacuation surgery alone. Because MMAE is a safe procedure, it should be considered for patients with cSDH, especially those with a high risk of recurrence.</p></sec>