Middle meningeal artery (MMA) embolization is a procedure performed on patients who have a subdural hematoma or blood collecting in the space around the brain.
MMA embolization aims to decrease blood supply to the lining of the brain, the source of the bleeding. It does not immediately decrease the size of the subdural hematoma, but encourages the body to reabsorb the blood over weeks or months.
Sometimes, MMA embolization is the only treatment for subdural hematomas. Other times it may be performed before or after surgical drainage of the subdural hematoma.
How is MMA embolization performed?
A specialist will insert a catheter through a small incision near your thigh or wrist into a large blood vessel, using x-ray as a guide to enter the blood vessel in the tissue layer around the brain (note: this artery does not supply blood to the brain).
We inject embolic material - medical grade glue, microparticles or platinum coils - to block blood flow through this artery. At the end of the procedure, we remove the catheter and bandage the puncture site in the thigh or wrist is closed. You can remove this small bandage 24 hours after your procedure.
Are there risks?
MMA embolization is safe but there are always risks associated with a procedure, including:
- Bleeding
- Infection
- Blood vessel injury
- Reaction to the contrast dye
- Loss of vision
- Seizure
- Stroke
In serious cases, coma and even death are possible.
What happens after the procedure?
After the procedure, you must lay flat in bed in the recovery room with your legs straight for three hours. You can then slowly sit upright and walk. You will spend one night in the hospital under close monitoring. Nurses will take your vital signs, perform neurological exams and check your pulses and puncture site periodically. If there are no concerns, you will be discharged the next morning.
What will happen once I’m home?
You will be tired from the medication so resting is important. We advise against driving and making important decisions for at least 24 hours. You can use 650mg of Tylenol every 6 hours as needed.
You can take the bandage off 24 hours after the procedure and leave the area open to air. Continue to monitor the site for the next week. You can shower 24 hours after the procedure. Gently wash the area with soap and water, patting dry with a clean towel. Do not rub the area. Avoid strenuous activity, lifting more than 10 pounds, hot tubs and riding a bike for a week. You can resume a regular diet, home medications and light activity such as walking.
What should I look out for?
Monitor the area for redness, swelling, drainage, pain, bleeding or weakness/numbness in your leg. Bruising is normal, but if you notice oozing from the site, experience swelling that is tense or your leg becomes cold or weak, please contact our office or 911 immediately.