{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:04:49Z","timestamp":1782842689711,"version":"3.54.5"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Despite a rapidly growing body of literature supporting the treatment of chronic subdural hematoma (cSDH) with middle meningeal artery embolization (MMAE), real-life data is still scarce. This study aimed to evaluate MMAE radiological and clinical outcomes, based on radiological characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Fifty-two cSDH patients, treated by MMAE as a post-CSDH evacuation therapy in a single tertiary center, were included. Radiological outcome was evaluated with cSDH thickness\/volume difference at routine follow-up compared to pre-MMAE CT head imaging. The cohort was divided into groups pertaining to cSDH laterality (bilateral and unilateral cSDH) and pre-MMAE hematoma thickness (&gt;15 mm and \u226415 mm) for analysis. Patients who underwent evacuation\n                      <jats:italic>after<\/jats:italic>\n                      MMAE were not included in the analysis to eliminate bias of surgical effect on hematoma progression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty patients had bilateral, and 22 patients had unilateral cSDH treated with bilateral and unilateral MMAE respectively. Twenty-nine patients had &gt;15 mm pre-MMAE hematoma thickness, and 23 had \u226415 mm pre-MMAE hematoma thickness. Mean cSDH volume was lower at all follow-up intervals when compared to baseline and was reduced by a factor of 10 at the 3\u20136-month interval. The mean cSDH thickness was significantly lower at all three follow-up intervals when comparing each group (bilateral and unilateral MMAE) (pre-treatment hematoma thickness &gt;15 mm and \u226415 mm). Larger hematomas with a thickness of &gt;15 mm had a significantly greater reduction in mean cSDH volume interval follow-up than hematomas measuring \u226415 mm (1\u20133 months\u201463 mm\n                      <jats:sup>3<\/jats:sup>\n                      , 40.6\u201385.69,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Unilateral cSDH and MMAE demonstrated greater cSDH volume reduction compared to bilateral cSDH and MMAE at 1\u20133 months (42, 15.2\u201368.8, .001) and 3-6 months (33.7, 5.2-72.7, .043). No procedure-related major complications or deaths or recurrences were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjunctive MMAE after surgical evacuation appears safe and effective. MMAE is particularly effective for larger pre-treatment hematomas &gt;15 mm (compared to \u226415 mm) and for unilateral cSDH and MMAE (compared to bilateral cSDH and MMAE).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251328563","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T03:39:41Z","timestamp":1745897981000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The effect of pre-treatment hematoma size and unilateral vs bilateral MMA embolization on volume reduction in the treatment of chronic subdural hematomas: A retrospective cohort study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-6635","authenticated-orcid":false,"given":"Andrew","family":"Falzon","sequence":"first","affiliation":[{"name":"Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abdelghafar","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eef","family":"Hendriks","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo Andrade","family":"Barazarte","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kostynskyy","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Boutet","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8320-4129","authenticated-orcid":false,"given":"Ze\u2019ev","family":"Itsekzon-Hayosh","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5111-1972","authenticated-orcid":false,"given":"Pascal J.","family":"Mosimann","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Neurosurgery, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1981.54.5.0637"},{"key":"e_1_3_3_3_2","article-title":"Paradigms in chronic subdural hematoma pathophysiology: current treatments and new directions","volume":"91","author":"Bounajem MT","unstructured":"Bounajem MT, Campbell RA, Denorme F, et al. 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