{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:56:16Z","timestamp":1781794576586,"version":"3.54.5"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Chronic subdural hematomas (cSDHs) are increasingly common in aging populations, driven by the rising use of anticoagulant and antiplatelet therapies. Middle meningeal artery embolization (MMAE) is a promising minimally invasive treatment. This study projects the future US incidence of cSDH through 2050 and estimates MMAE demand based on hematoma size criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors utilized data from the National Inpatient Sample from 2016 to 2019 to calculate age-specific incidence rates of cSDH. Institutional CT scans of the head from a level I comprehensive trauma center were analyzed to determine the distribution of cSDH sizes and MMAE eligibility thresholds (5, 8, 10, and 15 mm). Population projections were obtained from the 2023 datasets of the US Census Bureau.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 531 institutional cSDH patients, the mean hematoma thickness was 13.0 \u00b1 13.3 mm, with 75.0% exceeding 5 mm, 56.3% exceeding 8 mm, and 14.3% exceeding 15 mm. Using the &gt; 8-mm eligibility threshold, the projected MMAE population increases from 39,294 patients in 2022 to 44,596 by 2050 (13.5% increase, p &lt; 0.0001). If a more generous &gt; 5-mm threshold is applied, projections rise from 52,338 in 2022 to 59,401 in 2050 (p &lt; 0.0001). Conversely, applying a high-severity &gt; 15-mm threshold yields a smaller but still substantial cohort, increasing from 7594 to 8618 over the same period (p &lt; 0.0001). Total cSDH cases are expected to grow from 69,794 in 2022 to 79,212 in 2050.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The projected increase in cSDH and the corresponding rise in MMAE-eligible patients signify a substantial emerging public health challenge. Anticipating a 13.5% growth in incidence by 2050, these findings emphasize the urgent need for proactive healthcare planning and resource allocation to accommodate the escalating demand for specialized interventions like MMAE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.9.jns25749","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T01:47:54Z","timestamp":1770428874000},"page":"1499-1505","source":"Crossref","is-referenced-by-count":0,"title":["Forecasting the rise of middle meningeal artery embolization for chronic subdural hematoma patients: United States projections from 2022 to 2050"],"prefix":"10.3171","volume":"144","author":[{"given":"Avi A.","family":"Gajjar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"},{"name":"Department of Neurosurgery, Albany Medical Center, Albany, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander D. M.","family":"Gerlach","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilayda","family":"Kayir","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"},{"name":"Bah\u00e7e\u015fehir School of Medicine, Istanbul, Turkey; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashad","family":"Jabarkheel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed M.","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"},{"name":"Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleg","family":"Shekhtman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua S.","family":"Catapano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Karl","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Visish M.","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Brain Spine","first-page":"100300","article-title":"Chronic subdural hematoma (cSDH): a review of the current state of the art","volume":"1","author":"Nouri A","year":"2021","unstructured":"Nouri A, Gondar R, Schaller K, Meling T. Chronic subdural hematoma (cSDH): a review of the current state of the art. Brain Spine. 2021;1:100300."},{"issue":"3","key":"b2","series-title":"J Neurosurg","first-page":"887","article-title":"Chronic subdural hematoma","volume":"114","author":"Gelabert-Gonz\u00e1lez M","year":"2011","unstructured":"Gelabert-Gonz\u00e1lez M, Serramito-Garcia R. Chronic subdural hematoma. J Neurosurg. 2011;114(3):887\u2013888."},{"issue":"2","key":"b3","series-title":"Neurosurg Clin N Am","first-page":"211","article-title":"Chronic subdural medical management","volume":"28","author":"Roh D","year":"2017","unstructured":"Roh D, Reznik M, Claassen J. Chronic subdural medical management. Neurosurg Clin N Am. 2017;28(2):211\u2013217."},{"key":"b4","series-title":"World Neurosurg","first-page":"954","article-title":"Chronic subdural hematoma: a perspective on subdural membranes and dementia","volume":"108","author":"Sahyouni R","year":"2017","unstructured":"Sahyouni R, Goshtasbi K, Mahmoodi A, Tran DK, Chen JW. Chronic subdural hematoma: a perspective on subdural membranes and dementia. World Neurosurg. 2017;108:954\u2013958."},{"issue":"9","key":"b5","series-title":"Acta Neurochir (Wien)","first-page":"2629","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 DJ","year":"2021","unstructured":"Stubbs DJ, Vivian ME, Davies BM, Ercole A, Burnstein R, Joannides AJ. Incidence of chronic subdural haematoma: a single-centre exploration of the effects of an ageing population with a review of the literature. 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Accessed October 21, 2025. https:\/\/www.census.gov\/topics\/population\/age-and-sex\/data\/tables.html"},{"key":"b15","series-title":"World Neurosurg","first-page":"e166","article-title":"Increases in subdural hematoma with an aging population\u2014the future of American cerebrovascular disease","volume":"141","author":"Neifert SN","year":"2020","unstructured":"Neifert SN, Chaman EK, Hardigan T,  Increases in subdural hematoma with an aging population\u2014the future of American cerebrovascular disease. World Neurosurg. 2020;141:e166\u2013e174."},{"issue":"1","key":"b16","series-title":"Neurosurg Rev","first-page":"262","article-title":"Comparative outcomes of middle meningeal artery embolization with statins versus embolization alone in the treatment of chronic subdural hematoma: a systematic review and meta-analysis","volume":"46","author":"Musmar B","year":"2023","unstructured":"Musmar B, Spellicy S, Salim H,  Comparative outcomes of middle meningeal artery embolization with statins versus embolization alone in the treatment of chronic subdural hematoma: a systematic review and meta-analysis. 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Neurosurgery. 2023;93(5):1082\u20131089."},{"issue":"12","key":"b20","series-title":"J Neurointerv Surg","first-page":"1313","article-title":"Standalone middle meningeal artery embolization versus middle meningeal artery embolization with concurrent surgical evacuation for chronic subdural hematomas: a multicenter propensity score matched analysis of clinical and radiographic outcomes","volume":"16","author":"Chen H","year":"2024","unstructured":"Chen H, Salem MM, Colasurdo M,  Standalone middle meningeal artery embolization versus middle meningeal artery embolization with concurrent surgical evacuation for chronic subdural hematomas: a multicenter propensity score matched analysis of clinical and radiographic outcomes. 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Chronic subdural medical management. Neurosurg Clin N Am. 2017;28(2):211\u2013217."},{"key":"b4","series-title":"World Neurosurg","first-page":"954","article-title":"Chronic subdural hematoma: a perspective on subdural membranes and dementia","volume":"108","author":"Sahyouni R","year":"2017","unstructured":"Sahyouni R, Goshtasbi K, Mahmoodi A, Tran DK, Chen JW. Chronic subdural hematoma: a perspective on subdural membranes and dementia. World Neurosurg. 2017;108:954\u2013958."},{"issue":"9","key":"b5","series-title":"Acta Neurochir (Wien)","first-page":"2629","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 DJ","year":"2021","unstructured":"Stubbs DJ, Vivian ME, Davies BM, Ercole A, Burnstein R, Joannides AJ. Incidence of chronic subdural haematoma: a single-centre exploration of the effects of an ageing population with a review of the literature. Acta Neurochir (Wien). 2021;163(9):2629\u20132637."},{"key":"b6","series-title":"World Neurosurg","first-page":"622","article-title":"Middle meningeal artery embolization for chronic subdural hematoma: current state and future directions","volume":"139","author":"Gilligan J","year":"2020","unstructured":"Gilligan J, Gologorsky Y. Middle meningeal artery embolization for chronic subdural hematoma: current state and future directions. World Neurosurg. 2020;139:622\u2013623."},{"issue":"6","key":"b7","series-title":"J Neurosurg","first-page":"1679","article-title":"Enlargement of the middle meningeal artery on MR angiography in chronic subdural hematoma","volume":"124","author":"Takizawa K","year":"2016","unstructured":"Takizawa K, Sorimachi T, Ishizaka H,  Enlargement of the middle meningeal artery on MR angiography in chronic subdural hematoma. J Neurosurg. 2016;124(6):1679\u20131683."},{"issue":"4","key":"b8","series-title":"J Neurointerv Surg","first-page":"329","article-title":"Middle meningeal artery embolization for chronic subdural hematoma: an effective treatment with a bright future","volume":"16","author":"Levitt MR","year":"2024","unstructured":"Levitt MR, Hirsch JA, Chen M. Middle meningeal artery embolization for chronic subdural hematoma: an effective treatment with a bright future. J Neurointerv Surg. 2024;16(4):329\u2013330."},{"issue":"e3","key":"b9","series-title":"J Neurointerv Surg","first-page":"e349","article-title":"Updated estimates of large and medium vessel strokes, mechanical thrombectomy trends, and future projections indicate a relative flattening of the growth curve but highlight opportunities for expanding endovascular stroke care","volume":"15","author":"Rai AT","year":"2023","unstructured":"Rai AT, Link PS, Domico JR. 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Neurosurg Rev. 2023;46(1):262."},{"key":"b17","series-title":"Front Neurol","first-page":"1206996","article-title":"Incidence, therapy, and outcome in the management of chronic subdural hematoma in Switzerland: a population-based multicenter cohort study","volume":"14","author":"El Rahal A","year":"2023","unstructured":"El Rahal A, Beck J, Ahlborn P,  Incidence, therapy, and outcome in the management of chronic subdural hematoma in Switzerland: a population-based multicenter cohort study. Front Neurol. 2023;14:1206996."},{"issue":"5","key":"b18","series-title":"J Neurosurg","first-page":"1209","article-title":"Actual and projected incidence rates for chronic subdural hematomas in United States Veterans Administration and civilian populations","volume":"123","author":"Balser D","year":"2015","unstructured":"Balser D, Farooq S, Mehmood T, Reyes M, Samadani U. 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Neurosurgery. 2023;93(5):1082\u20131089."},{"issue":"12","key":"b20","series-title":"J Neurointerv Surg","first-page":"1313","article-title":"Standalone middle meningeal artery embolization versus middle meningeal artery embolization with concurrent surgical evacuation for chronic subdural hematomas: a multicenter propensity score matched analysis of clinical and radiographic outcomes","volume":"16","author":"Chen H","year":"2024","unstructured":"Chen H, Salem MM, Colasurdo M,  Standalone middle meningeal artery embolization versus middle meningeal artery embolization with concurrent surgical evacuation for chronic subdural hematomas: a multicenter propensity score matched analysis of clinical and radiographic outcomes. 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