Middle meningeal artery embolization for the treatment of small acute epidural hematomas
Objective. The purpose of this study was to investigate the efficacy of early-stage endovascular surgery to treat small acute epidural hematomas. Methods. The study group consisted of 6 consecutive patients harboring small-to medium-sized EDHs treated by MMA embolization between 2014 and 2020. Results. Active contrast leaking from the MMA was seen in 1 case; arteriovenous fistulas between the MMA and diploic veins were seen in 4 cases and MMA pseudoaneurysms were found in all cases. Embolizations were performed under local anesthesia with N-butyl-2-cyanoacrylate obtaining MMA occlusion and complete resolution of the vascular lesions. All patients underwent follow-up CT scans in 7 days after the embolization. Decrise size of the EDH was observed and the clinical evolution was uneventful. Conclusions. This study suggests that MMA embolization is a highly effective and safe method to achieve size stabilization in nonsurgically treated acute EDHs.