{
  "abstract": "Introduction While surgical evacuation remains the main treatment, middle meningeal artery (MMA) embolization has emerged as a minimally invasive alternative. This study evaluates the relative efficacy and safety of these two approaches in a carefully selected patient cohort.Aim of Study To compare the efficacy, safety, and recurrence rates of MMA embolization and surgical evacuation in the management of subacute or chronic SDH using prospectively and retrospectively collected clinical data.Method We analyzed 23 patients treated between January 2024 and April 2025. Ten patients underwent MMA embolization (prospective), and thirteen underwent surgical evacuation (retrospective). Inclusion criteria: age 18–90, pre-morbid mRS ≤3, and subacute/chronic SDH. Exclusion criteria: acute SDH, life expectancy <1 year, coagulopathy, intracranial tumor or infection. Outcomes assessed included hematoma resolution (<10mm is considered positive outcome), complications, and mortality. Hematoma thickness and reduction percentages were calculated for both ipsilateral and contralateral sides during follow-up.Results In the surgery group (n=13), there was one mortality. Average hematoma thickness was 18.46 mm with 64.37% reduction. 2 patients with recurrences (15.38%), 1 with increased hematoma thickness. Six had contralateral hematomas (avg. 14.5 mm, 78.52% reduction). In the embolization group (n=10), no mortality occurred. 1 patient with recurrence (10%). Average hematoma thickness was 14.45 mm with 79.54% reduction. Five had contralateral hematomas (avg. 9.2 mm, 91.35% reduction). Two minor complications occurred post-embolization: one pseudoaneurysm which resolved spontaneously and one premature catheter tip detachment, both without clinical consequence.Conclusion MMA embolization resulted in higher hematoma resolution, no mortality, and minor non-disabling complications compared to surgical evacuation.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Antalya Education and Research Hospital, Antalya, Türkiye"
      ],
      "name": "Ender Uysal"
    },
    {
      "affiliations": [
        "Antalya Education and Research Hospital, Antalya, Türkiye"
      ],
      "name": "Cemre Can Çayırcı"
    },
    {
      "affiliations": [
        "Antalya Education and Research Hospital, Antalya, Türkiye"
      ],
      "name": "Tolga Gediz"
    },
    {
      "affiliations": [
        "Antalya Education and Research Hospital, Antalya, Türkiye"
      ],
      "name": "Gülsüm Akar"
    }
  ],
  "title": "A150 Comparison of outcomes between mma embolization and surgery in subacute/chronic subdural hematomas",
  "uid": "fc495174-d0c4-5165-9c20-670723706109"
}