Middle meningeal artery embolization combined with burr hole drainage to treat chronic subdural hematoma: Single-center experience and prognostic analysis

Background: This study evaluated the efficacy of middle meningeal artery (MMA) embolization/embolization combined with burr hole drainage to treat CSDH and analyze the factors affecting patient prognosis. Methods: This retrospective analysis utilized the clinical data of 242 patients with CSDH who were treated in the Department of Neurosurgery at our hospital between January 2020 and January 2024. The patients were categorized into the burr hole drainage and MMA embolization/embolization combined with burr hole drainage groups. Baseline data, clinical information, imaging data, and follow-up data were collected from both groups. Treatment efficacy and prognosis were compared between the groups. Results: Patients in the embolization/embolization combined with burr hole group were significantly younger than those in the burr hole drainage group, and the distribution of burr hole sides significantly differed between the groups. In the embolization/embolization combined with burr hole drainage group, MMA embolization was successfully performed in 55 patients. Short-term follow-up illustrated that the symptoms and signs of most patients were improved, giving a short-term improvement rate of 89.3 %. Long-term prognostic analysis identified the surgical method as an important factor affecting patient prognosis, and the long-term improvement rate was significantly higher in the embolization/embolization combined with burr hole group than in the burr hole drainage group. Conclusion: MMA embolization/embolization combined with burr hole drainage is effective for treating CSDH, as it can improve the long-term prognosis of patients and reduce the risk of recurrence.