Middle Meningeal Artery Embolization Versus Surgery For Chronic Subdural Hematoma: A Systematic Review and Meta-analysis
Omar Abbas1, Roaa Haddad2, Rwan Hegazy3, Hala AbouShawareb4, Abdullah Almarfadi5, Mohab Saad1, Yousif Hanafi1, Afaf Bachira Gouhiri6, Youmna Zain7, Dalia Abouda8
1Faculty of Medicine, Al-Azhar University, Cairo, Egypt., 2October 6 university, Cairo, Egypt, 3Faculty of Pharmacy, damnhor University, Cairo, Egypt., 4Faculty of Medicine,Mansoura University, Cairo, Egypt., 5Ferhat Abbas University of Setif ยท Department of Medicine, Setif, Algeria, 6Ben Youcef Ben Khedda University, 7Faculty of Medicine, Tanta University, Cairo, Egypt., 8Faculty of medicine, Alexandria university, Alexandria, Egypt
Objective:

This meta-analysis aimed to compare clinical outcomes between  MMAE and surgery in patients with cSDH.

Background:

Chronic subdural haematoma (cSDH) is a common neurological condition, particularly among the elderly. The incidence is increasing globally. Surgical procedure is the most common approach for cSDH. Although middle meningeal artery embolisation (MMAE) has evolved as a minimally invasive alternative technique. For a better medical procedure.

Design/Methods:

The study was conducted through PubMed, Scopus, Web of Science and Cochrane until March 2025. Analysis was performed using the random-effects model. The outcomes measured were mortality, treatment failure, length of hospital stay, and reoperation. Results have been reported as risk ratios (RR) with confidence intervals (CI).

Results:

Five studies reported mortality rates of 3% with MMAE and 9.2% with surgery (RR = 0.74, 95% CI 0.40–1.39; p = 0.35). Treatment failure was significantly lower with MMAE (RR = 0.69, 95% CI 0.49–0.98; p = 0.039). No significant difference was found in hospital stay (MD = –1.39, 95% CI –3.46 to 0.69; p = 0.19) or reoperation rate (RR = 0.55, 95% CI 0.22–1.37; p = 0.19). Complication rates were comparable (RR = 1.01, 95% CI 0.77–1.32; p = 0.94).

Conclusions:
Our study suggests the use of MMAE as a novel therapeutic approach for cSDH with a minimally invasive strategy. Randomized clinical trials may be needed in the future with a longer follow-up duration
10.1212/WNL.0000000000216377
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.