Standalone middle meningeal artery embolization vs. surgical evacuation in chronic subdural hematoma: A comprehensive systematic review and meta-analysis.

Authors

• Ibrahim Mohammadzadeh
• Bardia Hajikarimloo
• Sai Sanikommu
• Amirhossein Zare
• Ali Mortezaei
• Saba Aghajani
• Ahmad Alagha
• Misagh Iranpour
• Mohammad Amin Habibi
• Kivanc Yangi
• Seyed Ali Mousavinejad
• Farzan Fahim
• Adam A Dmytriw
• Redi Rahmani
• Vratko Himic
• Ricardo J Komotar
• Khaled M Taghlabi
• Amir H Faraji
• Emade Jaman
• Ahmed Abdelsalam
• Ahmet Günkan
• Peter Kan
• Jason P Sheehan
• Robert M Starke
• Pascal Jabbour

Publication/Presentation Date

3-11-2026

Abstract

BackgroundChronic subdural hematoma (cSDH) remains a prevalent neurosurgical condition in elderly patients, traditionally managed via surgical evacuation when symptomatic. Middle meningeal artery embolization (MMAE) has recently emerged as a minimally invasive alternative. However, the comparative efficacy and safety of standalone MMAE versus standalone surgical evacuation remain inadequately defined.MethodsA comprehensive search of PubMed, Scopus, Embase, and Web of Science, was performed on March 20, 2025. Studies comparing standalone MMAE and standalone surgical evacuation in patients with cSDH were included. The primary outcome was recurrence; secondary outcomes included complication and mortality rates. A random-effects pairwise meta-analysis model using restricted maximum likelihood (REML) was applied to account for between-study variability.ResultsTen studies encompassing 50,138 patients were included. Recurrence was significantly lower with MMAE (RR = 0.51, 95% CI: 0.33-0.80, p = .00), with no statistically detected heterogeneity (I

First Page

19714009261432000

Last Page

19714009261432000

ISSN

2385-1996

Published In/Presented At

Mohammadzadeh, I., Hajikarimloo, B., Sanikommu, S., Zare, A., Mortezaei, A., Aghajani, S., Alagha, A., Iranpour, M., Habibi, M. A., Yangi, K., Mousavinejad, S. A., Fahim, F., Dmytriw, A. A., Rahmani, R., Himic, V., Komotar, R. J., Taghlabi, K. M., Faraji, A. H., Jaman, E., Abdelsalam, A., … Jabbour, P. (2026). Standalone middle meningeal artery embolization vs. surgical evacuation in chronic subdural hematoma: A comprehensive systematic review and meta-analysis. The neuroradiology journal, 19714009261432000. Advance online publication. https://doi.org/10.1177/19714009261432000

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

41811919

Department(s)

Administration and Leadership

Document Type

Article