Middle Meningeal Artery Embolization for Subdural Hematoma

Chronic subdural hematoma (cSDH) is a common neurosurgical disease that is increasing in incidence worldwide. While surgical evacuation can relieve mass effect and alleviate neurologic symptoms, drainage alone does not address underlying cSDH pathophysiology, likely resulting in high rates of recurrence. Middle meningeal artery embolization (MMAE) has emerged as a promising adjunct to conventional cSDH to reduce recurrence risk. Despite positive results from multiple randomized controlled trials demonstrating MMAE efficacy, questions remain about its optimal role in routine patient care. This review summarizes the contemporary management of cSDH, discusses the emerging role of MMAE, and highlights lingering questions and future directions.