Meningeal Artery Embolization

What is it?

Middle meningeal artery embolization, (MMA embolization), is a minimally invasive procedure that treats chronic subdural hematomas (cSDH), a slow collection of blood between the brain and its outer covering. Using a tiny catheter, a doctor delivers special materials to block the middle meningeal artery, the blood vessel that feeds the membranes causing the hematoma to persist or grow.

Why is it done?

This procedure is performed to:

• Reduce or stop the blood flow that allows the hematoma to continue or recur
• Treat patients with chronic subdural hematomas after a head injury
• Lower the chance of the hematoma coming back after surgery
• Offer a treatment option for patients who may not be good candidates for open surgery

During the Procedure

• The procedure is typically done under local anesthesia with sedation, though general anesthesia may be used in certain cases
• A small puncture is made in an artery in your groin or wrist
• A thin catheter is guided through the blood vessels to the middle meningeal artery using X-ray guidance
• Microscopic particles, liquid embolic agents, or coils are released to block the artery’s blood flow to the hematoma membranes
• The catheter is removed and the puncture site is closed with gentle pressure or a closure device

After the Procedure

• Most patients remain in the hospital for monitoring, often for less than 24 hours
• You may need to lie flat for a few hours to help the puncture site heal
• Mild headache, fatigue, or soreness at the access site is possible
• Follow-up imaging, such as CT or MRI, is scheduled to monitor the hematoma’s size
• Your care team will give instructions about activity restrictions and follow-up appointments

While MMA embolization is considered safe and less invasive than open surgery, possible risks include:

• Bleeding or bruising at the puncture site
• Allergic reaction to contrast dye
• Vessel injury or blockage of unintended blood vessels
• Stroke or neurological changes (rare)
• Recurrence of the hematoma

Your medical team will review your individual risks and benefits before the procedure.