Failure of MMA embolization due to deep and middle temporal artery supply in chronic subdural hematoma: the diagnostic value of 3D-RA.

Masaomi Takeuchi, Yoichi Morofuji, Yuki Matsunaga, Chieko Inoue, Eri Shiozaki, Takayuki Matsuo

Abstract readCase Reports

In one paragraph

Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Masaomi TakeuchiDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Yoichi MorofujiDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. morofujiyoichi@gmail.com.ORCID 0000-0001-7135-2220

Yuki MatsunagaDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Chieko InoueDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Eri ShiozakiDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Takayuki MatsuoDepartment of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

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No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic subdural hematoma (CSDH) is commonly managed with burr hole evacuation, yet recurrence remains frequent. Middle meningeal artery (MMA) embolization has emerged as a minimally invasive treatment. We describe the case of an 85-year-old man with refractory CSDH who developed multiple recurrences despite repeated surgical evacuation and MMA embolization. Three-dimensional rotational angiography (3D-RA) revealed atypical transosseous feeders from the anterior and middle deep temporal arteries and the middle temporal artery. Targeted embolization using N-butyl cyanoacrylate and coils resulted in durable hematoma resolution without further recurrence. This case highlights the importance of detailed vascular assessment with 3D-RA when MMA embolization fails.

Indexed as

Embolization, TherapeuticHematoma, Subdural, ChronicMeningeal ArteriesTemporal ArteriesAged, 80 and overCerebral AngiographyHumansImaging, Three-DimensionalMaleTreatment FailureChronic subdural hematomaDeep temporal artery embolizationMiddle meningeal artery embolizationMiddle temporal artery embolization

Identifiers

PMID41991629

DOI10.1007/s00701-026-06882-8

PMCPMC13212704

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.