Open Access
CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1811712
Case Report

A Case of Acute Epidural Hematoma Successfully Treated with Middle Meningeal Artery Embolization

Akihiro Shimoi
1   Department of Neurosurgery, Institute of Brain and Blood Vessels, Isesaki, Gunma-ken, Japan
,
1   Department of Neurosurgery, Institute of Brain and Blood Vessels, Isesaki, Gunma-ken, Japan
,
Hironori Takahashi
1   Department of Neurosurgery, Institute of Brain and Blood Vessels, Isesaki, Gunma-ken, Japan
,
Kazuma Kowata
1   Department of Neurosurgery, Institute of Brain and Blood Vessels, Isesaki, Gunma-ken, Japan
,
Kazunori Akaji
1   Department of Neurosurgery, Institute of Brain and Blood Vessels, Isesaki, Gunma-ken, Japan
› Author Affiliations
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Abstract

We report a case of acute epidural hematoma (AEDH) successfully treated with middle meningeal artery (MMA) embolization. A 59-year-old man presented with headache 2 days after minor head trauma. Head computed tomography (CT) revealed a left-sided AEDH with an associated skull fracture. Although the patient had only mild disturbance of consciousness and no focal neurological deficits, the hematoma volume was significant. Given the absence of mass effect and to prevent further hematoma expansion, emergent MMA embolization was performed via a transradial approach under local anesthesia. Angiography demonstrated contrast extravasation from the MMA, which was successfully embolized using 20% n-butyl-2-cyanoacrylate. The patient's postoperative course was uneventful, and the hematoma showed near-complete resolution on follow-up CT 1 month later. This case highlights the potential utility of MMA embolization as a minimally invasive and effective treatment option for select AEDH cases that do not require emergency craniotomy.



Publication History

Article published online:
18 September 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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