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Neuroradiol J2026;19714009261432000.March 11, 2026Journal Article

Standalone middle meningeal artery embolization vs. surgical evacuation in chronic subdural hematoma: A comprehensive systematic review and meta-analysis.

Ibrahim Mohammadzadeh1, Bardia Hajikarimloo2, Sai Sanikommu3, Amirhossein Zare4, Ali Mortezaei5, Saba Aghajani6, Ahmad Alagha1, Misagh Iranpour1, Mohammad Amin Habibi7, Kivanc Yangi8, Seyed Ali Mousavinejad1, Farzan Fahim1, Adam A Dmytriw9,10, Redi Rahmani11, Vratko Himic12, Ricardo J Komotar12, Khaled M Taghlabi13, Amir H Faraji13, Emade Jaman3, Ahmed Abdelsalam3, Ahmet Günkan14, Peter Kan15, Jason P Sheehan2, Robert M Starke3, Pascal Jabbour16
1Skull Base Research Center, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Iran.
2Department of Neurological Surgery, University of Virginia, USA.
3Department of Neurological Surgery, Radiology, Neurosciences, Pharmacology, University of Miami School of Medicine, USA.
4Neurology Department, Tehran University of Medical Sciences, Iran.
5Student Research Committee, Gonabad University of Medical Sciences, Iran.
6Department of Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Iran.
7Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Iran.
8The Loyal and Edith Davis Neurosurgical Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, USA.
9Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, USA.
10Neurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Canada.
11Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, USA.
12Department of Neurological Surgery, University of Miami Miller School of Medicine, USA.
13Department of Neurological Surgery, Houston Methodist Hospital, USA.
14Division of Vascular and Interventional Radiology, Department of Radiology and Imaging Sciences, University of Arizona, USA.
15Department of Neurosurgery, University of Texas Medical Branch, USA.
16Neurological Surgery, Thomas Jefferson University, USA.
PubMed PMC DOI PDF

Abstract

BackgroundChronic subdural hematoma (cSDH) remains a prevalent neurosurgical condition in elderly patients, traditionally managed via surgical evacuation when symptomatic. Middle meningeal artery embolization (MMAE) has recently emerged as a minimally invasive alternative. However, the comparative efficacy and safety of standalone MMAE versus standalone surgical evacuation remain inadequately defi…

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