Middle meningeal artery embolisation for chronic subdural haematomas

Status:

In progress

Technology type:

Procedure

Decision:

Selected

Reason for decision:

Anticipate the topic will be of importance to patients, carers, professionals, commissioners and the health of the public to ensure clinical benefit is realised, inequalities in use addressed, and help them make the best use of NHS resources

Process:

IP

ID number:

1887

Description:

A subdural haematoma is an accumulation of blood in the space between the brain and its surrounding membrane (subdural space). It’s usually caused by a head injury. The collection of blood causes pressure on the brain, which can lead to headache, motor and cognition problems and reduced consciousness. The hematoma is considered chronic if the blood has been present for some time, often weeks or months. People who are asymptomatic or have minor symptoms with smaller haematomas are usually offered conservative treatment with careful monitoring and medical management. People who have more severe symptoms and larger haematomas, and who have acceptable surgical risks, are offered surgical drainage through a burr hole or small craniotomy. But these procedures are not always effective, and the hematoma can often reappear – in up to a fifth of people. Chronic subdural hematomas are much more common in people over 65. The incidence of chronic subdural hematomas is set to rise as the British population ages and as antithrombotic agents are used more frequently. Middle meningeal artery embolisation (MMAE) is a minimally invasive procedure in which the blood supply to the hematoma is restricted by injecting an embolic (blocking) agent. A catheter is usually inserted into the common femoral or radial artery, and a microcatheter is then guided into the middle meningeal artery (MMA). The blocking agent is then injected into this artery to stop the blood supply to the membrane around the haematoma, allowing the haematoma to resolve on its own and reducing the risk of recurrence. MMAE can be used in addition to surgery and as a primary treatment option for people with chronic subdural hematomas. This topic has been selected for interventional procedures assessment, which aims to assess the efficacy and safety of new and significantly modified procedures, or established procedures if there is uncertainty about their efficacy or safety.

Provisional Schedule

Draft scope consultation:

11 December 2025 - 07 January 2026

Scope Published:

26 January 2026

Email enquiries

If you have any queries please email IP@nice.org.uk

Timeline

Key events during the development of the guidance:

For further information on how we develop interventional procedures guidance, please see our interventional procedures programme manual