P.157 Adjunctive treatment of chronic subdural hematoma with middle meningeal artery embolization – is the left side more common?

Abstract

Background: Embolization of middle meningeal artery (EMMA) is an emerging treatment for CSDH and a method to decrease CSDH recurrence. We report a single Canadian center experience of EMMA for the management of CSDH. Methods: Consecutive EMMA patients during the period July 2020 to September 2021 were retrospectively included in this series. EMMA procedures were performed using polyvinyl alcohol particles or liquid embolic agent. All patients were followed clinically and radiographically as per standard of care. Results: A total of 20 patients CSDH (mean 65.6 years; range 14-85 yrs; male 16) underwent 20 EMMA procedures. CSDH occured on the left in 13 patients, right in 4 patients and bilateral in 3 patients. No patients had periprocedural complications. There was no recurrence of CSDH on the EMMA treated side. The mean SDH size decreased from 18.4 +/- 6.34 mm at the time of presentation to 5.31 +/ 3.84 mm at last follow up. The proportion of patients with an mRS of 2 or less increased from 65% to 76%. Conclusions: EMMA was found to be effective and safe in the management of CSDH with no evidence of recurrence on the treated side. Left sided hematomas appear to be more common that right sided hematomas.