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Chronic subdural hematoma occurs when blood builds up between the brain and its protective outer layer, the dura mater. This usually happens following a minor head injury.

This condition happens when tiny blood vessels in the outer layer of the brain burst. This causes blood to collect in the space between the vessels. It’s important to understand how our nervous system, blood flow, and clotting work to grasp how to treat this issue.

What is Chronic Subdural Hematoma?

Chronic subdural hematoma is a condition where blood collects under the skull but outside the brain, following a head bump or injury. Imagine you hit your head slightly, and instead of a big, immediate problem, a slow leak starts under the skull, on top of the brain. This doesn’t happen right away but builds up over weeks or even months.

At first, you might not notice anything wrong because the symptoms can be very mild. However, as more blood accumulates, it can start pressing on the brain. This pressure can lead to headaches, confusion, weakness on one side of the body, or even more severe issues like seizures or difficulty speaking.

The brain is enclosed in a tough, protective layer called the dura mater. When small blood vessels between the brain’s outer layer and this protective cover break, blood starts to collect in the space between them, known as the subdural space.

This collection of blood is what we call a chronic subdural hematoma. It’s different from other types of brain injuries because it grows slowly, and the symptoms can take a while to show up, making it tricky to diagnose right after an injury. Understanding this condition is important because it affects how the brain functions, influencing everything from movement to how we think and feel.

Traditional Treatments and Their Issues

When someone has a chronic subdural hematoma, the usual way doctors try to fix it is by performing surgery. This might sound scary, but it’s all about getting rid of the blood that shouldn’t be there and making sure the brain isn’t being squeezed.

These surgeries, like making small holes in the skull (called burr hole surgery) or opening up a larger area (known as craniotomy), are effective. However, they’re not perfect. Imagine going through one of these procedures: they’re big deals that come with risks like infections or other complications, especially if you’re older or already have health problems.

And let’s not forget, recovering from brain surgery isn’t quick or easy. You might have to spend a lot of time in the hospital and then more time recovering at home, which means missing out on work, school, or fun activities.

Plus, even after going through all this, there’s still a chance the problem could come back, which would mean more treatments or surgeries. So, while these traditional methods have been the go-to solutions, they’re not ideal for everyone, pushing doctors and researchers to look for better, safer options.

Introducing MMA Embolization

MMA embolization is a newer, less invasive way to tackle chronic subdural hematoma. It specifically targets the middle meningeal artery (MMA), a key player in the blood supply to the area where these hematomas occur. By carefully guiding a catheter to the MMA and introducing tiny particles to block it, doctors can reduce the risk of more bleeding.

This technique is groundbreaking because it addresses the problem right at its source without the need for opening up the skull. It’s a big win for patients, especially those who might be too frail for traditional surgery or who want to avoid the longer recovery times and higher risks associated with bigger operations.

The beauty of MMA embolization lies in its simplicity and effectiveness. By cutting down the blood supply to the problematic area, it helps prevent the condition from coming back, offering a more permanent solution. This method showcases the incredible advances in medical technology, providing new hope for safer, more efficient treatments that can significantly improve patients’ quality of life without the downsides of conventional surgery.

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How MMA Embolization Works

A doctor inserts a small tube into the MMA through the wrist. The tube sends tiny particles that stop blood flow to the tissue. This stops more blood from pooling and allows the body to naturally get rid of the blood that has already collected. This treatment is a big leap forward, offering a precise way to fix issues related to the nervous system and blood vessels.

Benefits of MMA Embolization

This method is less invasive, meaning fewer risks like infections or other surgery-related issues. It also means a quicker recovery time, letting patients get back to their normal activities faster. By tackling the abnormal blood vessel directly, it also lessens the chances of another hematoma forming.

Evidence in Favor

Studies have found that MMA embolization can make hematomas smaller and improve symptoms without requiring additional surgeries. This is promising news and suggests it could become a go-to treatment.

What’s Next?

As researchers conduct more studies, MMA embolization could revolutionize the treatment of chronic subdural hematomas. Its simplicity and effectiveness make it a preferred choice for doctors and patients alike. With ongoing improvements in medical technology, we might see even better treatments in the future.

Conclusion

Chronic subdural hematoma has been a tough condition to treat, but MMA embolization offers new hope. By directly addressing the cause in a less invasive way, it presents an efficient alternative to traditional surgeries. As we learn more about this procedure, the outlook for patients with this condition is getting brighter.

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Dr. Dorthea Altschul

About Dr. Dorothea Altschul

MD, FAHA, FSVIN

Dr. Dorothea Altschul is an accomplished neurointerventionalist in North Jersey and is the Clinical Director of Endovascular Services at Neurosurgeons of New Jersey, practicing out of their Ridgewood office located on East Ridgewood Avenue.

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