{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:28:27Z","timestamp":1786512507232,"version":"build-2736575974"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the feasibility, safety, and short-term outcomes of adjunctive middle meningeal artery (MMA) embolization using low-viscosity liquid embolic agents (1:1 diluted Onyx\/DMSO and 1:9 diluted Glubran 2\/Ethiodized Poppyseed Oil Injection) for acute epidural hematoma (AEDH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 9 consecutive AEDH patients evaluated for MMA embolization at our institution. Eight underwent embolization, and one was converted to immediate craniotomy after pre-procedural cranial CT showed rapid hematoma expansion. In the embolization subgroup, low-viscosity agents included 1:1 diluted Onyx with dimethyl sulfoxide (DMSO) (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f6) and 1:9 diluted Glubran 2\/ethiodized oil (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f2). Primary observations included technical success, radiographic evolution, clinical outcomes, and periprocedural complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Technical success was achieved in all embolized cases (8\/8). Across the eight embolized cases, low-viscosity agents reached distal dural branches without relevant proximal reflux, and no catheter adherence or catheter entrapment was observed. No procedure-related complications occurred. Follow-up imaging showed stable or resolving hematomas in all embolized patients, and none required rescue surgery for post-embolization expansion. Median discharge GCS was 15, and no new neurologic deficits were observed. In the non-embolized conversion case, immediate pre-procedural CT showed interval progression, and prompt craniotomy was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In selected AEDH patients, adjunctive MMA embolization with low-viscosity liquid embolic agents (1:1 diluted Onyx\/DMSO and 1:9 diluted Glubran 2\/ethiodized oil) was technically feasible with a favorable short-term safety profile and may help control bleeding and reduce the risk of hematoma expansion while balancing distal penetration and catheter control. This strategy may provide a minimally invasive treatment option for high-risk AEDH, but multicenter studies with larger retrospective case series are needed for confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1896356","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:45:14Z","timestamp":1786509914000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series"],"prefix":"10.3389","volume":"17","author":[{"given":"Hualong","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaohua","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinqing","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ruijin Hospital, Shanghai Jiaotong University School of Medcine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiantian","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minfang","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jili","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulei","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuping","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suqin","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junfeng","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Operating Room, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongmei","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Operating Room, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxia","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Operating Room, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuling","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Taicang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","first-page":"S7","article-title":"Surgical management of acute epidural hematomas","volume":"58","author":"Bullock","year":"2006","journal-title":"Neurosurgery"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.wneu.2017.11.047","article-title":"Novel minimally invasive treatment strategy for acute traumatic epidural hematoma: endovascular embolization combined with drainage surgery and use of urokinase","volume":"110","author":"Zhang","year":"2018","journal-title":"World Neurosurg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1017\/cjn.2015.232","article-title":"Epidural hematoma treated conservatively: when to expect the worst","volume":"43","author":"Basamh","year":"2016","journal-title":"Can J Neurol 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