Middle Meningeal Artery Embolization as Targeted Adjunct for Chronic Subdural Hematoma in the Elderly

MMAE is a promising mechanism-targeted adjunct for selected high-risk chronic subdural hematoma patients, not a universal replacement for surgery. cSDH is now understood as a vascular-inflammatory disease, with incidence rising steeply in super-aged societies.

• cSDH is now reframed as a self-perpetuating process driven by inflammation, pathological angiogenesis, and hyperfibrinolysis.
• Rising incidence in aging populations is making cSDH a significant neurointerventional and public health concern.
• Standardized technique and longer-term outcome data are still needed before widespread adoption of MMAE.

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