====== Middle Meningeal Artery Embolization ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1XKgVAYRUbsFD9uhDnaGMBc8nTt9kw_zJKd75M1c0TGQBpzIpF/?limit=15&utm_campaign=pubmed-2&fc=20240201072856}}

===== Indications =====


see [[Middle meningeal artery embolization for chronic subdural hematoma]].
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[[Middle meningeal artery]] (MMA) embolization has been increasingly applied in adult populations for the treatment of chronic subdural hematomas (cSDH). There is a paucity of literature on the indications, safety, and outcomes of MMA embolization in the pediatric population.

A systematic literature review on pediatric patients undergoing MMA embolization was performed. We also report the case of successful bilateral MMA embolization for persistent subdural hematomas following resection of a juvenile pilocytic astrocytoma. Persistent bilateral subdural hematomas following resection of a large brain tumor resolved following MMA embolization in a 13-year-old male. Indications for MMA embolization in the pediatric literature included cSDH (6/13, 46.2%), treatment or preoperative embolization of arteriovenous fistula or arteriovenous malformation (3/13, 23.1%), preoperative embolization for tumor resection (1/13, 7.7%), or treatment of acute epidural hematoma (1/13, 7.7%). Embolic agents included microspheres or microparticles (2/13, 15.4%), Onyx (3/13, 23.1%), NBCA (3/13, 23.1%), or coils (4/13, 30.8%).

Whereas MMA embolization has primarily been applied in the adult population for subdural hematoma in the setting of cardiac disease and anticoagulant use, we present a novel application of MMA embolization in the management of persistent subdural hematoma following resection of a large space-occupying lesion. Systematic review of MMA embolization in pediatric patients currently shows efficacy; multi-institutional study is warranted to further refine indications, timing, and safety of the procedure
((Vazquez S, Zuckerman DA, Gandhi C, Al-Mufti F, Muh C, Santarelli J, Pisapia JM. Middle Meningeal Artery Embolization in Pediatric Patients. Pediatr Neurosurg. 2023 Oct 30. doi: 10.1159/000534895. Epub ahead of print. PMID: 37903471.))