Chronic Subdural Hematoma Treatment With MMA Embolization

A minor bump to the head can seem harmless at first. Then, weeks later, headaches start, walking feels unsteady, or a loved one seems more confused than usual. These are common signs of a subdural hematoma, a slow bleed between the brain and its outer covering that mostly affects older adults.

Surgery can drain the blood, but some hematomas refill. Research finds that adding middle meningeal artery (MMA) embolization to surgery lowered the rate of repeat surgery from about 11% to about 4%. Continue reading to learn how this minimally invasive procedure works, when it is needed, and what to look for when searching for the best neurosurgeon for middle meningeal artery embolization in West Hills.

How Does a Chronic Subdural Hematoma Develop?

As we age, the brain shrinks slightly and pulls away from the skull. This stretches the small veins that bridge the gap, and even a mild jolt can tear them. Blood then collects slowly over days or weeks. Your body tries to wall off the blood with thin membranes. These membranes grow fragile new blood vessels that leak, so the collection can keep growing. Factors that raise your risk of a chronic subdural hematoma include:

• Age 65 and older
• Blood thinners, including anticoagulant and antiplatelet medicines
• Frequent falls or balance problems
• Heavy alcohol use
• A prior head injury, even a minor one

Subdural Hematoma Symptoms That Can Appear Weeks After a Fall

Because the bleed grows slowly, symptoms can creep up and look like normal aging. If you or a loved one has had a fall or been involved in an accident, you should watch for:

• Headaches that persist or worsen
• Confusion, memory lapses, or trouble focusing
• Weakness or numbness on one side of the body
• Trouble walking or new falls
• Slurred speech
• Drowsiness or changes in behavior

Call 911 right away for sudden weakness, trouble speaking, or a seizure. For symptoms that build over time, a neurological evaluation and a CT scan or MRI can confirm the diagnosis.

Can Subdural Hematomas Return After Surgery?

Traditional treatment for chronic subdural hematomas uses a burr hole or a small skull opening to drain the blood. Drainage relieves pressure on the brain, but it leaves the leaky membranes behind. Those membranes draw their blood supply from the middle meningeal artery, a vessel that runs along the inside of the skull. As long as that supply stays open, the membranes can keep bleeding. MMA embolization targets this source directly, which is why it lowers the chance of a repeat bleed.

What Happens During Middle Meningeal Artery Embolization?

MMA embolization takes place in an angiography suite, a procedure room with real-time X-ray imaging. Most patients receive local anesthesia with light sedation. The procedure follows these steps:

• A neurosurgeon inserts a thin catheter through a small puncture in the wrist or groin
• Using imaging guidance, they guide the catheter through your blood vessels to the middle meningeal artery
• They release tiny particles or a liquid embolic agent to close off the branches that feed the membranes
• They remove the catheter and close the puncture site with a small bandage

The procedure usually takes one to two hours. Most people stay overnight for observation and go home the next day. Over the following weeks to months, your body gradually reabsorbs the remaining blood.

Comparing Treatment Options for a Chronic Subdural Hematoma

When looking for the best neurosurgeon for middle meningeal artery embolization in West Hills, look for a care team that will recommend an approach based on the size of the hematoma, your symptoms, and your overall health. Treatment options may include:

Who is a Good Candidate for MMA Embolization?

MMA embolization can be a primary treatment or an added step after surgery. A specialist may recommend it if you:

• Had a subdural hematoma return after surgical drainage
• Have health conditions that make open surgery riskier
• Take blood thinners for a heart rhythm problem, a stent, or a past clot
• Have mild to moderate symptoms, including headaches or balance changes
• Want to lower the chance of needing another operation

Need to Find the Best Doctor for Chronic Subdural Hematoma in West Hills?

Our neuroendovascular team at the Vascular and Neuroscience Institute treats chronic subdural hematomas with minimally invasive MMA embolization through the wrist or groin, guided by real-time imaging. Many patients avoid open brain surgery, and those who still need drainage gain added protection against a repeat bleed.

Dr. Asif Taqi leads our multidisciplinary team and holds five board certifications in neurology, vascular neurology, neurocritical care, critical care neurology, and neuroendovascular surgery. He completed fellowships in vascular neurology, neurocritical care, and endovascular interventional neuroradiology at the University of Tennessee and the Medical College of Wisconsin. His role in national clinical trials keeps our team current on the newest devices and techniques. 

For families looking for the best neurosurgeon for middle meningeal artery embolization in West Hills, our team at our West Hills office inside the Woodlake Medical Center is ready to walk you through your treatment options.