To evaluate the safty and effect of the treatment of middle meningeal artery (MMA) embolization combined with hematoma drainage on chronic subdural hematoma (CSDH).

From July 2019 to Feburary 2021, forty CSDH patients received surgical treatment in Beijing Chaoyang Hospital, Capital Medical University. Thirty five of them recived hematoma drainage. Five patients recieved MMA embolization, and if necessary, extra hematoma drainage. Selective branches of MMA embolizations was performed by Onyx. After embolization, the hematoma drainage was perfomed immediately if obvious mass effect or midline shift was confirmed on computer tomography (CT) scan. Hematoma volume resorption, recurrence and complications associated with treatment was observed during follow up.

One hundred persent of the operations were successful. Hematoma volume reduced in all the patients and no recurrence and complication that related to the treatment was seen during the follow up. Thirty-five patients received hematoma drainage. The average follow up time was (8.1 ± 3.7) weeks, two recurrences (5.7%) were seen during follow up. Five CSDH patients received a total of 7 MMA embolizations. Four of the 5 patients were primary CSDH, one of the 5 patients was recurrent. A total of 3 patients underwent unilateral interventions and 2 of them underwent bilateral interventions. The median follow up time was (19.0 ± 7.0) weeks.

Method of MMA embolization combined with hematoma drainage was safe and effective in treating CSDH, and futher result to be expected.