• Shunsuke Tanoue, Kenichiro Ono, Terushige Toyooka, Hidenori Okawa, Kojiro Wada, and Toshiki Shirotani.
• Department of Neurosurgery, Mishuku Hospital, Tokyo, Japan; Department of Neurosurgery, National Defense Medical College Hospital, Saitama, Japan. Electronic address: stanoue@ndmc.ac.jp.
• World Neurosurg. 2023 Mar 1; 171: e120e125e120-e125.

ObjectiveA few reports have demonstrated the efficacy of middle meningeal artery embolization (MMAE) alone for mildly symptomatic chronic subdural hematoma (CSDH); however, the clinical course in the early posttreatment period remains unclear. The purpose of this study was to analyze the short-term outcomes of this technique at our center.MethodsThis study was based on a retrospective analysis of a single-center consecutive case series. Patients with mildly symptomatic CSDH treated with MMAE alone between July 2020 and June 2022 were examined. Neurological examinations and head computed tomography scans were performed before treatment and 1, 7, 14, and 28 days after treatment. The clinical course of the patients was analyzed. In particular, symptom improvement within 1 week from treatment or rescue evacuation and the factors associated were evaluated.ResultsFifteen patients were included in this study. No procedure-related complications occurred. Partial or complete recovery within the first week from treatment was observed in 10 cases (66.7%), and the symptoms resolved completely in a median of 26 (6.5-33.5) days. Rescue evacuation was needed in 3 cases (20.0%). The hematoma volume and midline shift gradually decreased from baseline, with a significant improvement within the first week (P = 0.030 and 0.0032, respectively).ConclusionsMMAE alone provides relatively early improvement in cases of mildly symptomatic CSDH and may be a potential alternative to surgical evacuation or medical therapy.Copyright © 2022 Elsevier Inc. All rights reserved.

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