Efficacy and safety of middle meningeal artery embolization in combination with burr hole craniostomy for chronic subdural hematomas: A single-center experience

Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition. The mass effect of hematoma could lead to a series of neurological dysfunctions. Surgical intervention, such as burr hole craniostomy (BHC), is often recommended due to persistent symptoms, but recurrence rates remain significant. Middle meningeal artery embolization (MMAE) is a promising treatment strategy for CSDH, this study aims to evaluate the efficacy and safety of MMAE in combination with BHC for managing CSDH. A comparative analysis was conducted on 101 patients (harboring 123 CSDHs) who underwent either burr hole craniostomy alone or combined therapy with burr hole craniostomy and MMAE. Data on demographic information, clinical characteristics, treatment modalities, and outcomes were collected and analyzed. Combined therapy with burr hole craniostomy and MMAE resulted in lower recurrence rates compared to burr hole craniostomy alone. Complication rates were similar between groups, and MMAE was technically successful in all cases. Patients in the combined therapy group showed an improved GOS score at the predefined 6-month follow-up. Middle meningeal artery embolization, when combined with burr hole craniostomy, represents a safe and effective approach for managing CSDH, resulting in reduced recurrence rates and improved short-term outcomes.