Middle meningeal artery embolization with N-Butyl Cyanoacrylate (NBCA) for the treatment of chronic subdural hematoma – Technical note

Chronic subdural hematoma (cSDH) is classically defined as a collection of blood in the space between the dura mater and arachnoid meninges. Endovascular treatment for selected cases of chronic subdural hematoma has been increasingly reported in the literature, being the embolization of the middle meningeal artery (MMA) the most used technique, though the best embolization material is still subject to studies. Methods: we present the detailed description of the technique for MMA embolization with a 20% solution of NBCA for the treatment of chronic subdural hematoma. Discussion: Endovascular treatment for selected cases of chronic subdural hematoma has been increasingly reported in the literature, being the embolization of the MMA the most used technique, though the best embolization material is still subject to studies. NBCA is a low-cost embolic agent that has been used for a long time in endovascular treatments. Conclusion: There is great potential for MMA embolization in the management of chronic subdural hematomas, either as a single or adjuvant treatment. NBCA represents an effective and low-cost material.