{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:43:23Z","timestamp":1788911003403,"version":"build-2803163510"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2021,9]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Middle meningeal artery (MMA) embolization is an emerging minimally invasive endovascular technique for chronic subdural hematoma (cSDH). Currently, limited literature exists on its safety and efficacy compared with conventional treatment (open-surgical-evacuation-only).<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To compare MMA embolization to conventional treatment.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Retrospective analysis of patients with cSDHs treated with MMA embolization in a single center from 2018 to 2019 was performed. Comparisons were made with a historical conventional treatment cohort from 2006 to 2016. Propensity score matching analysis was used to assemble a balanced group of subjects.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n A total of 357 conventionally treated cSDH and 45 with MMA embolization were included. After balancing with propensity score matching, a total of 25 pairs of cSDH were analyzed. Comparing the embolization with the conventional treatment group yielded no significant differences in complications (4%\u00a0vs 4%;\n P<\/jats:italic>\n \u00a0>\u00a0.99), clinical improvement (82.6%\u00a0vs 83.3%;\n P<\/jats:italic>\n \u00a0=\u00a0.95), cSDH recurrence (4.3%\u00a0vs 21.7%;\n P<\/jats:italic>\n \u00a0=\u00a0.08), overall re-intervention rates (12%\u00a0vs 24%;\n P<\/jats:italic>\n \u00a0=\u00a0.26), modified Rankin scale >2\u00a0on last follow-up (17.4%\u00a0vs 32%;\n P<\/jats:italic>\n \u00a0=\u00a0.24), as well as mortality (0%\u00a0vs 12%;\n P<\/jats:italic>\n \u00a0=\u00a0.09). Radiographic improvement at last follow-up was significantly higher in the open surgery cohort (73.9%\u00a0vs 95.6%;\n P<\/jats:italic>\n \u00a0=\u00a0.04). However, there was a trend for lengthier last follow-up for the historical cohort (72\u00a0vs 104 d;\n P<\/jats:italic>\n \u00a0=\u00a0.07).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n There was a trend for lower recurrence and mortality rates in the embolization era cohort. There were significantly higher radiological improvement rates on last follow-up in the surgical only cohort era. There were no significant differences in complications and clinical improvement.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyab192","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T09:26:18Z","timestamp":1620293178000},"page":"486-495","source":"Crossref","is-referenced-by-count":63,"title":["Middle Meningeal Artery Embolization Versus Conventional Treatment of Chronic Subdural Hematomas"],"prefix":"10.1227","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6091-390X","authenticated-orcid":false,"given":"Alejandro","family":"Enriquez-Marulanda","sequence":"first","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2283-3612","authenticated-orcid":false,"given":"Santiago","family":"Gomez-Paz","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed M","family":"Salem","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akashleena","family":"Mallick","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rouzbeh","family":"Motiei-Langroudi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Arle","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3284-7639","authenticated-orcid":false,"given":"Martina","family":"Stippler","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8146-4872","authenticated-orcid":false,"given":"Efstathios","family":"Papavassiliou","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7306-3577","authenticated-orcid":false,"given":"Ron L","family":"Alterman","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7538-8095","authenticated-orcid":false,"given":"Christopher S","family":"Ogilvy","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin M*","family":"Moore","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajith J","family":"Thomas","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,9]]},"reference":[{"issue":"9","key":"bib1-20231012","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1136\/neurintsurg-2019-014730","article-title":"Middle meningeal artery embolization for the management of chronic subdural hematoma","volume":"11","author":"Fiorella","year":"2019","journal-title":"J Neurointerv Surg"},{"issue":"2","key":"bib2-20231012","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.wneu.2018.11.167","article-title":"Middle meningeal artery embolization for chronic subdural hematoma: meta-analysis and systematic review","volume":"122","author":"Srivatsan","year":"2019","journal-title":"World Neurosurg"},{"issue":"6","key":"bib3-20231012","doi-asserted-by":"crossref","first-page":"e473","DOI":"10.1016\/j.wneu.2019.02.074","article-title":"Enhanced hematoma membrane on DynaCT images during middle meningeal artery embolization for persistently recurrent chronic subdural hematoma","volume":"126","author":"Nakagawa","year":"2019","journal-title":"World Neurosurg"},{"issue":"6","key":"bib4-20231012","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.3171\/2015.5.JNS1567","article-title":"Enlargement of the middle meningeal artery on MR angiography in chronic subdural hematoma","volume":"124","author":"Takizawa","year":"2016","journal-title":"J Neurosurg"},{"issue":"3","key":"bib5-20231012","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1148\/radiol.2017170053","article-title":"Middle meningeal artery embolization for chronic subdural hematoma","volume":"286","author":"Ban","year":"2018","journal-title":"Radiology"},{"issue":"5","key":"bib6-20231012","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.wneu.2017.02.070","article-title":"Embolization therapy for refractory hemorrhage in patients with chronic subdural hematomas","volume":"101","author":"Kim","year":"2017","journal-title":"World Neurosurg"},{"issue":"3","key":"bib7-20231012","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jocn.2017.11.009","article-title":"Which surgical procedure is effective for refractory chronic subdural hematoma? Analysis of our surgical procedures and literature review","volume":"49","author":"Matsumoto","year":"2018","journal-title":"J Clin Neurosci"},{"issue":"1","key":"bib8-20231012","doi-asserted-by":"crossref","first-page":"194","DOI":"10.25259\/SNI_58_2019","article-title":"Spontaneous resolution of chronic subdural hematoma: does only the size matter?","volume":"10","author":"Junior","year":"2019","journal-title":"Surg Neurol Int"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neurosurgery\/article-pdf\/89\/3\/486\/39628944\/nyab192.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyab192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:58:52Z","timestamp":1786121932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyab192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,25]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyab192","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,25]]}}}