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When to Refer for Subdural Hematomas

Middle Meningeal Artery (MMA) Embolization

Proven, Minimally Invasive Treatment for Subdural Hematomas

Why It Matters

Chronic and recurrent subdural hematomas (SDH) are common in older, anticoagulated, and fragile patients. Traditional surgery often means recurrence, repeat procedures, and delays restarting anticoagulation.

Now, three randomized controlled trials in 2025 confirm MMA embolization as a safer, durable alternative.

Evidence from Landmark RCTs

  • MAGIC-MT (722 pts): Recurrence 7.2% vs. 12.2%
  • EMBOLISE (400 pts, surgical cases): Repeat surgery 4.1% vs. 11.3%
  • STEM (310 pts): Composite outcome (recurrence, rescue surgery, major adverse events) 16% vs. 36%

Bottom line: Across trials, MMA embolization halved recurrence and complications.

Why Refer to Dr. Brian Snelling & Marcus Neuroscience Institute

  • 7 years’ experience, 200+ MMA embolizations – among the most experienced programs nationwide
  • Outpatient, radial-access ERAS protocol – patients home same day
  • Early anticoagulation restart – critical for stroke, AFib, and cardiac patients
  • Proven safety – ideal for elderly and medically fragile
Mehrdad Ghoreishi, M.D.

Brian Snelling, MD

When to Refer

  • Recurrent or chronic SDH after burr hole or craniotomy
  • Elderly, anticoagulated, or high-risk surgical patients
  • Progressive chronic/subacute SDH with symptoms

Key Takeaway

MMA embolization is a proven therapy for patients with subdural hematoma.

Refer your patients directly to Dr. Brian Snelling at Marcus Neuroscience Institute for a minimally invasive, evidence-backed treatment that reduces recurrence, shortens recovery, and enables safe anticoagulation resumption.

To discuss a case or refer, email bsnelling@baptisthealth.net or call 561-955-2455

 


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