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Middle Meningeal Artery Embolization: A Paradigm Shift in Approach of Chronic Subdural Hematoma
Journal article   Peer reviewed

Middle Meningeal Artery Embolization: A Paradigm Shift in Approach of Chronic Subdural Hematoma

Hamza Hanif, Shanza Farook, Sajid S. Suriya, Muhammad Umer Riaz Gondal, Muhammad Ibraiz Bilal and Abu Baker Sheikh
Journal of community hospital internal medicine perspectives, v 12(5), pp 25-35
09 Sep 2022
PMID: 36262498
url
https://doi.org/10.55729/2000-9666.1086View
Published, Version of Record (VoR) Open

Abstract

Review
Chronic subdural hematoma (SDH) is commonly seen in the aged population. It is hypothesized to occur due to damage to the dural border cells, resulting in an inflammation–proliferation reaction. Inadequate repair leads to the formation of an external layer of cells and fragile capillaries, which are vulnerable to damage, contributing to worsening of the condition. Conventionally, asymptomatic chronic SDH was managed by observation, while symptomatic cases by surgical evacuation. However, the recurrence rate of chronic SDH after surgical evacuation was high. The middle meningeal artery (MMA) provides blood supply to the dura mater and feeds the capillaries of the membranes covering the SDH. MMA embolization blocks blood flow to this system and promotes hematoma resolution. In this manuscript, we discuss the underlying pathophysiology and current management options for chronic SDH. We also discuss the existing literature on MMA embolization.

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