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All Journal Indonesian Journal of Global Health Research
Pande Putu Bagus Premana
Windu Husada Hospital

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Radiographic and Angiographic Predictors of Response after Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Kadek Virginia Mas Cahya Dewi; Pande Putu Bagus Premana
Indonesian Journal of Global Health Research Vol. 8 No. 6 (2026): Indonesian Journal of Global Health Research: December 2026
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i6.2724

Abstract

Middle meningeal artery embolization (MMAE) is a minimally invasive treatment for chronic subdural hematoma (cSDH), yet predictors of treatment response remain incompletely defined. To evaluate radiographic, angiographic, and procedural predictors of treatment response after MMAE in adults with cSDH. The literature search, covering January 2000 to June 2026, identified 582 records from PubMed, the Cochrane Library, and ScienceDirect. After screening and eligibility assessment, 11 studies were included in the narrative synthesis. Septated, laminar, and trabecular hematomas were associated with better or faster response, whereas homogeneous or separated architecture, residual thickness, mixed density, and greater midline shift were associated with delayed resolution or failure. Small MMA diameter and limited distal embolic penetration were linked to poorer outcomes, while greater embolic volume favored radiographic resolution. Embolizing additional branches or selectively targeting the dominant branch did not consistently improve outcomes. MMAE response depends on hematoma biology, vascular anatomy, and embolic distribution rather than a single imaging variable, offering a framework that may help guide risk stratification, patient selection, and follow-up planning in research on MMAE.
Co-Authors Kadek Virginia Mas Cahya Dewi