Morya AK, Behera RK, Gupta PC. Middle meningeal artery embolisation in chronic subdural hematoma: A double-edged sword. World J Clin Cases 2025; 13(28): 109364 [DOI: 10.12998/wjcc.v13.i28.109364]
Corresponding Author of This Article
Arvind K Morya, MD, Professor, Research Professor, Senior Researcher, Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India. bulbul.morya@gmail.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Middle meningeal artery embolisation in chronic subdural hematoma: A double-edged sword
Arvind K Morya, Ranjan K Behera, Parul C Gupta
Arvind K Morya, Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
Ranjan K Behera, Parul C Gupta, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandīgarh 160012, UT Chandīgarh, India
Co-first authors: Arvind K Morya and Ranjan K Behera.
Author contributions: Behera RK and Morya AK conceptualized the manuscript; Gupta PC did the literature search, and all three edited and wrote the manuscript; Morya AK submitted the final edited manuscript with all the necessary documents.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arvind K Morya, MD, Professor, Research Professor, Senior Researcher, Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India. bulbul.morya@gmail.com
Received: May 9, 2025 Revised: May 22, 2025 Accepted: July 17, 2025 Published online: October 6, 2025 Processing time: 91 Days and 2.4 Hours
Abstract
Chronic subdural hematoma is essentially managed by surgical intervention. In recent times, middle meningeal artery embolisation has emerged as a less invasive procedure in such cases. The use of fine catheters to selectively embolise the specific involved branches of the middle meningeal artery using polyvinyl alcohol particles looks promising; however, the presence of anastomotic arteries can result in reflux and embolisation of these atypical branches, causing a myriad of complications. There is a need to identify these abnormal vessels in time to have a positive outcome with the least complications.
Core Tip: Chronic subdural hematoma management involves middle meningeal artery embolisation in association with standard surgical procedures. The embolisation procedure selectively blocks the involved artery but may result in other local complications due to anastomotic arteries. Identifying these abnormal branches and adapting to alternate materials and interventional techniques is essential to prevent such issues.
