{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:40:01Z","timestamp":1756316401182,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,18]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>An older male presented with intermittent headaches, reduced mobility and transient facial weakness. CT head scan revealed acute-on-chronic subdural haematoma (cSDH), causing mass effect and midline shift. A background of progressive acute myeloid leukaemia was reported, characterised by severe thrombocytopaenia resistant to haematological therapies. The risk of neurosurgical intervention was deemed to be excessive.<\/jats:p>\n               <jats:p>Right middle meningeal artery embolisation (MMAE) was pursued to arrest repeated subdural haemorrhage and prevent symptomatic neurological deterioration. The patient was discharged home the following day. Interval CT head showed almost complete resolution of the right cSDH. Symptoms improved and the patient was able to return to living independently at home.<\/jats:p>\n               <jats:p>MMAE may be an effective intervention in patients with cSDH who are unsuitable candidates for surgery, and where the goal is to maintain functional independence, quality of life and prevent acute neurological decline and disability.<\/jats:p>","DOI":"10.1136\/bcr-2025-265331","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T07:08:54Z","timestamp":1743145734000},"page":"e265331","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Palliative middle meningeal artery embolisation for symptomatic chronic subdural haematoma in an individual with resistant thrombocytopaenia due to acute myeloid leukaemia"],"prefix":"10.1136","volume":"18","author":[{"given":"Alexandra","family":"Langberg","sequence":"first","affiliation":[{"name":"Interventional Radiology, NHS North Bristol NHS Trust, Bristol, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Dunkerton","sequence":"additional","affiliation":[{"name":"Interventional Radiology, NHS North Bristol NHS Trust, Bristol, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Shipway","sequence":"additional","affiliation":[{"name":"Geriatric Medicine, NHS North Bristol NHS Trust, Bristol, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Rickard","sequence":"additional","affiliation":[{"name":"Geriatric Medicine, NHS North Bristol NHS Trust, Bristol, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"2025082710230689000_18.3.e265331.1","doi-asserted-by":"crossref","first-page":"2629","DOI":"10.1007\/s00701-021-04879-z","article-title":"Incidence of chronic subdural haematoma: a single-centre exploration of the effects of an ageing population with a review of the literature","volume":"163","author":"Stubbs","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"2025082710230689000_18.3.e265331.2","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.78.916.71"},{"key":"2025082710230689000_18.3.e265331.3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/ane.13518","article-title":"Presenting symptoms and functional outcome of chronic subdural hematoma patients","volume":"145","author":"Blaauw","year":"2022","journal-title":"Acta Neurol Scand"},{"key":"2025082710230689000_18.3.e265331.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2018.01.050"},{"key":"2025082710230689000_18.3.e265331.5","doi-asserted-by":"crossref","first-page":"e134","DOI":"10.1097\/TA.0000000000003404","article-title":"Paradigms in chronic subdural hematoma pathophysiology: Current treatments and new directions","volume":"91","author":"Bounajem","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082710230689000_18.3.e265331.6","doi-asserted-by":"crossref","first-page":"6537","DOI":"10.1007\/s11357-024-01173-5","article-title":"Newer treatment paradigm improves outcomes in the most common neurosurgical disease of the elderly: a literature review of middle meningeal artery embolization for chronic subdural hematoma","volume":"46","author":"Debs","year":"2024","journal-title":"Geroscience"},{"key":"2025082710230689000_18.3.e265331.7","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-021602"},{"key":"2025082710230689000_18.3.e265331.8","doi-asserted-by":"crossref","first-page":"819","DOI":"10.3171\/2023.7.JNS231262","article-title":"Middle meningeal artery embolization as standalone treatment versus combined with surgical evacuation for chronic subdural hematomas: systematic review and meta-analysis","volume":"140","author":"Chen","year":"2024","journal-title":"J Neurosurg"},{"key":"2025082710230689000_18.3.e265331.9","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-022158"},{"key":"2025082710230689000_18.3.e265331.10","unstructured":"Bell J . STEM study finds improved outcomes with MMA embolisation over standard care in cSDH. NeuroNews International; 2024. Available: https:\/\/neuronewsinternational.com\/stem-study-finds-improved-outcomes-with-mma-embolisation-over-standard-care-in-csdh\/"},{"key":"2025082710230689000_18.3.e265331.11","unstructured":"Jason MD . Insights on the EMBOLISE trial and advancing treatment for subdural hematoma. 2024. Available: https:\/\/www.neurologylive.com\/view\/insights-on-the-embolise-trial-advancing-treatment-subdural-hematoma-jason-davies"},{"key":"2025082710230689000_18.3.e265331.12","doi-asserted-by":"crossref","first-page":"e1061","DOI":"10.1016\/j.wneu.2019.07.079","article-title":"Subdural Hematoma in Patients with Hematologic Malignancies: An Outcome Analysis and Examination of Risk Factors of Operative and Nonoperative Management","volume":"130","author":"Wright","year":"2019","journal-title":"World Neurosurg"},{"key":"2025082710230689000_18.3.e265331.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1995.tb08358.x"},{"key":"2025082710230689000_18.3.e265331.14","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1177\/19714009221147230","article-title":"Therapeutic efficacy and complications of radial versus femoral access in endovascular treatment of unruptured intracranial aneurysms","volume":"36","author":"Fuga","year":"2023","journal-title":"Neuroradiol J"},{"key":"2025082710230689000_18.3.e265331.15","doi-asserted-by":"crossref","first-page":"e694","DOI":"10.1016\/j.wneu.2022.05.031","article-title":"Transradial versus Transfemoral Approaches in Diagnostic and Therapeutic Neuroendovascular Interventions: A Meta-Analysis of Current Literature","volume":"164","author":"Ghaith","year":"2022","journal-title":"World Neurosurg"},{"key":"2025082710230689000_18.3.e265331.16","doi-asserted-by":"crossref","DOI":"10.25259\/SNI_1051_2022","article-title":"Middle meningeal artery embolization for symptomatic chronic subdural hematoma in the setting of severe transfusion-refractory thrombocytopenia: A case study and review of literature","volume":"14","author":"Morden","year":"2023","journal-title":"Surg Neurol Int"},{"key":"2025082710230689000_18.3.e265331.17","doi-asserted-by":"crossref","first-page":"47","DOI":"10.5797\/jnet.cr.2023-0084","article-title":"Middle Meningeal Artery Embolization for Refractory Chronic Subdural Hematoma Associated with Acute Myeloid Leukemia: A Case Report","volume":"18","author":"Kojima","year":"2024","journal-title":"J Neuroendovasc Ther"},{"key":"2025082710230689000_18.3.e265331.18","doi-asserted-by":"crossref","first-page":"3836","DOI":"10.1097\/JS9.0000000000000699","article-title":"Comparative study on clinical outcomes and cost-effectiveness of chronic subdural hematomas treated by middle meningeal artery embolization and conventional treatment: a national cross-sectional study","volume":"109","author":"Tong","year":"2023","journal-title":"Int J Surg"},{"key":"2025082710230689000_18.3.e265331.19","doi-asserted-by":"crossref","first-page":"e175","DOI":"10.1016\/j.wneu.2024.07.086","article-title":"Validity of the Cost-Effectiveness of Middle Meningeal Artery Embolization Following Hematoma Evacuation for Initial Chronic Subdural Hematoma","volume":"190","author":"Fujioka","year":"2024","journal-title":"World Neurosurg"},{"key":"2025082710230689000_18.3.e265331.20","doi-asserted-by":"crossref","first-page":"380","DOI":"10.7461\/jcen.2023.E2023.05.003","article-title":"Safety of middle meningeal artery embolization for treatment of subdural hematoma: A nationwide propensity score matched analysis","volume":"25","author":"McCann","year":"2023","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"key":"2025082710230689000_18.3.e265331.21","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-018327"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:23:15Z","timestamp":1756315395000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,28]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bcr-2025-265331"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265331","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}