Middle Meningeal Artery Embolization

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 10, 2026:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.00
Procedures: 1.00
Head, Spine, and Musculoskeletal: 1.00

Registered Radiologist Assistant: 2.75
Procedures: 2.75
Neurological, Vascular, and Lymphatic Sections: 2.75

Vascular-Interventional Radiography: 2.75
Procedures: 2.75
Vascular Interventional Procedures: 2.75

Outline

1. Introduction
2. Epidemiology
3. Pathophysiology of CSDH
4. Middle Meningeal Artery
   1. Variations in MMA Origin and Dangerous Collaterals
5. Initial Radiologic Assessment of CSDHs
6. Treatment
7. MMA Embolization Procedure
8. Radiologic Control Assessment of CSDH After MMA Embolization
9. Conclusion

Objectives

Upon completion of this course, students will:

1. identify the anatomical location where chronic subdural hematomas occur with-in the meningeal layers
2. recognize early imaging features of chronic subdural hematomas on CT scans
3. summarize current advancements in the treatment of chronic subdural hema-tomas
4. list risk factors that increase the likelihood of developing a chronic subdural hematoma
5. explain the reconsideration of traditional theories in the pathophysiology of chronic subdural hematoma
6. differentiate between chronic and acute subdural hematomas
7. describe the latency phase of chronic subdural hematoma and its clinical significance
8. identify the anatomical foramen through which the middle meningeal artery enters the cranial cavit
9. explain the role of the middle meningeal artery in the development and pro-gression of chronic subdural hematomas
10. describe the vascular changes in the middle meningeal artery associated with chronic subdural hematoma
11. determine the artery diameter associated with increased risk of embolization failure in chronic subdural hematoma treatment
12. justify the avoidance of proximal embolization near the foramen spinosum due to anatomical risks
13. identify the most common anatomical variant of the middle meningeal artery
14. recognize potential complications of middle meningeal artery embolization
15. recognize the most common presenting symptom in patients with chronic subdural hematoma
16. determine clinical scenarios where middle meningeal artery embolization is preferred over urgent surgical intervention
17. select the most accurate imaging technique for measuring subdural hema-toma thickness
18. recall the average recurrence rate of chronic subdural hematoma after surgical evacuation
19. describe the mechanisms by which middle meningeal artery embolization reduces the recurrence of chronic subdural hematoma
20. state the primary reason for using general anesthesia during middle menin-geal artery embolization procedures
21. identify the preferred vascular access site for middle meningeal artery em-bolization procedures
22. identify medications used intra-arterially to prevent vasospasm during mid-dle meningeal artery embolization
23. describe the initial imaging protocol before selective catheterization of the middle meningeal artery
24. identify the correct catheter positioning before embolic agent injection dur-ing middle meningeal artery embolization
25. explain the purpose of lidocaine administration through the microcatheter prior to embolization
26. describe the advantages of using liquid embolic agents in middle meninge-al artery embolization
27. identify the typical site of embolization when using coils or polyvinyl alcohol (PVA) particles during middle meningeal artery embolization procedures
28. list key radiological findings used in follow-up imaging to monitor the resolu-tion and progression of chronic subdural hematomas
29. determine appropriate patient selection criteria for middle meningeal artery embolization based on clinical presentation and recurrence history
30. recall the reported recurrence rate of chronic subdural hematoma following middle meningeal artery embolization