LAUSR

Abstract Chronic subdural hematomas (cSDH) are a common condition encountered by neurosurgeons with the potential for a high morbidity or mortality. A standard treatment regimen still remains highly discussed and controversial. Current treatments include surgical evacuation as well as medical therapies including statins, steroids, and tranexamic acid with ongoing studies to investigate their efficacy. Middle meningeal artery (MMA) embolization is a technique first described in the year 2000, which has shown promising results for cSDH treatment. The procedure is performed in the angiography suite under minimal sedation using embolization materials to block the MMA. This is thought to disrupt the primary blood supply to the cSDH allowing for resolution. Embolization can be utilized as the primary treatment or in addition to surgical evacuation. Current literature suggests that surgically evacuated cSDH can have a recurrence rate from 2% to 37% where the rate after MMA embolization is reported from 2.1% to 4.1%. When used as the primary treatment, MMA embolization can also potentially reduce the morbidity of a surgical procedure under general anesthesia to an elderly patient. Here we present a case of MMA embolization utilized after a postoperative cSDH recurrence with good results.