Middle Meningeal Artery (MMA) Embolization for Recurrent Subacute Subdural Hematoma With Complete Resolution Following Transient Radiological Size Progression: A Case Report and Literature Review

TL;DR

A 56-year-old woman with recurrent subdural hematoma showed significant improvement after middle meningeal artery embolization, despite initial radiological worsening.

Contribution

This case report documents a successful outcome of MMA embolization for RSDH with transient hematoma expansion, not well documented previously.

Findings

The patient showed near-complete resolution of hematoma over one year following MMA embolization.

Transient radiological hematoma expansion did not prevent long-term improvement.

MMA embolization may serve as an effective, minimally invasive alternative to surgery for RSDH.

Abstract

Recurrent subdural hematoma (RSDH) is a condition characterized by repeated blood accumulation beneath the dura mater, which often poses challenges in clinical management. Conventional surgical interventions, such as burr hole irrigation and drainage, are standard treatments but carry a risk of recurrence. Therefore, middle meningeal artery (MMA) embolization has recently emerged as a promising alternative to address RSDH.

This case report provides an overview of an RSDH in a 56-year-old female who underwent successful MMA embolization. She initially experienced a worsening of the hematoma with an acute-on-chronic component, which later regressed significantly, leading to near-complete resolution over a one-year follow-up period. Such an outcome has not been well documented in the existing literature and therefore represents an important case study that underscores the potential of MMA embolization as a viable option for RSDH, even in cases of transient post-procedural radiological hematoma expansion.

The findings emphasize the importance of careful patient monitoring and suggest that MMA embolization may offer an effective, minimally invasive alternative to surgery in select cases. It also highlights the need for ongoing research to determine the long-term effectiveness and safety of the procedure.

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