The objective of this case study is to investigate the role of middle meningeal artery embolization in the treatment of acute subdural hematoma.

Middle meningeal artery embolization is a relatively new treatment for subdural hematoma. Thus far, it has only been researched in the chronic setting. That is because it neutralizes neovascularizations which occur in the dura in the chronic setting. After neutralization, re-absorption of the blood can then occur without more blood leaking in from the neovascularizations. We sought out to investigate the unresearched possibility of preemptively neutralizing the neovascularizations in the acute setting in patients that would not tolerate an expansion of their hematoma.

We reviewed 5 cases in which middle meningeal artery embolization was performed for the treatment subdural hematoma in the acute setting. We tracked follow-up CT scans to track the progress of the resolution of the hematoma.

The results show a progressive improvement of the subdural hematoma over the course of several weeks in the patients reviewed. We did not note any expansions of bleeds or other post-surgical complications.

We conclude that middle meningeal artery embolization could be further researched as a treatment for acute subdural hematoma in select patients. Such a treatment has not yet been published.