1:1 Propensity Matched Cohort Study Evaluating MMA Embolization for Subdural Hematomas

The formation, progression, and recurrence of chronic subdural hematomas involves an imbalance between production and reabsorption of fluid. Middle meningeal artery embolization is an emerging treatment for chronic subdural hematomas that works to disrupt the vascular supply of subdural membranes and shift the balance in fluid accumulation. There have been several studies demonstrating that MMA embolization can be done effectively and safely.

Prior to this study, there have been several case series demonstrating the potential benefit of MMA embolization for chronic subdural hematomas with low complication rates. The authors conducted a 1:1 propensity score matching study with 25 patients in each arm, surgical and MMA embolization. The MMA embolization cohort had a trend towards a lower recurrence and mortality rate (p=0.08) although there were higher radiographic improvement rates in the surgical cohort. This may be due to the short length of follow-up.

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