TY - JOUR
AR - CRSS-2021-2-102
TI - Repeated Middle Meningeal Artery Embolization for Chronic Subdural  Hematoma Management: Case Report
AU - Kenneth, Sack
AU - George, Thomas
AU - Dimitri, Sigounas
JO - Case Reports and Series in Surgery
PY - 2021
DA - Fri 03, Sep 2021
SN - 2733-2241
DO - http://dx.doi.org/10.31487/j.CRSS.2021.02.02
UR - https://www.sciencerepository.org/repeated-middle-meningeal-artery-embolization_CRSS-2021-2-102 
KW - Meningeal arteries, chronic subdural hematoma, therapeutic embolization
AB - Aim: Middle Meningeal Artery (MMA) embolization has emerged as a viable neuroendovascular technique 
for the management of chronic subdural hematoma (SDH). Comparative analysis of various endovascular 
techniques for embolization is lacking. Guidance on operative techniques in situations of prior embolization 
failure is rare. 
Materials and Methods: In this case report, we present a patient with a chronic subdural hematoma that 
failed previous coil embolization of the MMA. Digital Subtraction Angiography showed the previously 
placed coil and continued distal flow to the dural membranes. 
Results: Onyx liquid embolization was completed successfully, effectively halting both anterograde flow 
to the MMA and retrograde flow from external circulation collaterals. 
Conclusion: This case report suggests that in situations of MMA embolization failure, follow-up 
angiography may be completed to determine if further embolization through other procedural techniques 
may be possible. The angiographic images contained here highlight the advantages of liquid embolization 
over coil embolization of the MMA in halting SDH angiogenesis.