E-ISSN 1658-7820
 
2026, Vol: 10, Issue: 9
10 / 9Current Issue Online First Archive Aims and Scope Abstracting & Indexing Most Accessed Articles Most Downloaded Articles Most Cited Articles

Review Article
Online Published: 09 Sep 2026
 


Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials

Roaa Alzaydi, Renad Almashyakhi, Hala Alduribi, Abdulrahman Alshayea, Nawaf Alharbi, Mohammed Alasmari, Mohammed Alharthi, Amal Alshaikh, Albaiyan Almasalami, Osama Althomali, Abdullah Tawakul.


Abstract
Chronic subdural hematoma (cSDH) recurs in approximately 10 to 30% of patients following surgical evacuation. Middle meningeal artery embolization (MMAE) targets the neo-angiogenic blood supply sustaining recurrence. This updated systematic review and meta-analysis pools all available randomized controlled trials (RCTs) of adjunctive MMAE versus standard care for chronic or non-acute subdural hematoma. PubMed, Scopus, Web of Science, and the Cochrane Library were searched from inception through April 2026. Eligible studies were RCTs comparing adjunctive MMAE plus standard care with standard care alone in adults with chronic or non-acute subdural hematoma. The primary outcome was recurrence or residual cSDH. Secondary outcomes included all-cause mortality, serious adverse events, favorable functional outcome (mRS 0–2 at 90 days), and major disabling stroke. Random-effects meta-analysis, Bayesian analysis, and trial sequential analysis (TSA) were performed. Evidence certainty was rated using the GRADE framework. PROSPERO [ID: CRD420261446040]. Six RCTs enrolling 2,093 participants were included. MMAE significantly reduced recurrence or residual cSDH (RR = 0.48, 95% CI = 0.30–0.76; I² = 41.3%; moderate certainty). Bayesian analysis con firmed this finding (posterior median RR = 0.48, 95% CrI = 0.32–0.70; 99.9% probability of benefit), and TSA confirmed information sufficiency. No significant differences were observed for all-cause mortality (RR = 0.92, 95% CI = 0.26–3.22; low certainty), serious adverse events (RR 0.90, 95% CI = 0.62–1.31), favorable functional outcome (RR = 1.01, 95% CI = 0.96–1.07), or major disabling stroke (RR = 1.18, 95% CI = 0.50–2.78). Adjunctive MMAE reduced cSDH recurrence by approximately half on moderate-certainty evidence. It does not significantly affect mortality, functional outcomes, or safety within current follow-up periods. The unresolved mortality signal requires longer-term investigation.

Key words: Chronic subdural hematoma, middle meningeal artery embolization, recurrence, meta-analysis, randomized controlled trials, systematic review


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Roaa Alzaydi
Articles by Renad Almashyakhi
Articles by Hala Alduribi
Articles by Abdulrahman Alshayea
Articles by Nawaf Alharbi
Articles by Mohammed Alasmari
Articles by Mohammed Alharthi
Articles by Amal Alshaikh
Articles by Albaiyan Almasalami
Articles by Osama Althomali
Articles by Abdullah Tawakul
on Google
on Google Scholar


How to Cite this Article
Pubmed Style

Alzaydi R, Almashyakhi R, Alduribi H, Alshayea A, Alharbi N, Alasmari M, Alharthi M, Alshaikh A, Almasalami A, Althomali O, Tawakul A. Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials. IJMDC. 2026; 10(9): 2920-2933. doi:10.24911/IJMDC.51-1785536046

Web Style

Alzaydi R, Almashyakhi R, Alduribi H, Alshayea A, Alharbi N, Alasmari M, Alharthi M, Alshaikh A, Almasalami A, Althomali O, Tawakul A. Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials. https://www.ijmdc.com/?mno=329685 [Access: September 19, 2026]. doi:10.24911/IJMDC.51-1785536046

AMA (American Medical Association) Style

Alzaydi R, Almashyakhi R, Alduribi H, Alshayea A, Alharbi N, Alasmari M, Alharthi M, Alshaikh A, Almasalami A, Althomali O, Tawakul A. Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials. IJMDC. 2026; 10(9): 2920-2933. doi:10.24911/IJMDC.51-1785536046


Vancouver/ICMJE Style

Alzaydi R, Almashyakhi R, Alduribi H, Alshayea A, Alharbi N, Alasmari M, Alharthi M, Alshaikh A, Almasalami A, Althomali O, Tawakul A. Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials. IJMDC. (2026), [cited September 19, 2026]; 10(9): 2920-2933. doi:10.24911/IJMDC.51-1785536046


Harvard Style

Alzaydi, R., Almashyakhi, . R., Alduribi, . H., Alshayea, . A., Alharbi, . N., Alasmari, . M., Alharthi, . M., Alshaikh, . A., Almasalami, . A., Althomali, . O. & Tawakul, . A. (2026) Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials. IJMDC, 10 (9), 2920-2933. doi:10.24911/IJMDC.51-1785536046


Turabian Style

Alzaydi, Roaa, Renad Almashyakhi, Hala Alduribi, Abdulrahman Alshayea, Nawaf Alharbi, Mohammed Alasmari, Mohammed Alharthi, Amal Alshaikh, Albaiyan Almasalami, Osama Althomali, and Abdullah Tawakul. 2026. Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials. International Journal of Medicine in Developing Countries, 10 (9), 2920-2933. doi:10.24911/IJMDC.51-1785536046


Chicago Style

Alzaydi, Roaa, Renad Almashyakhi, Hala Alduribi, Abdulrahman Alshayea, Nawaf Alharbi, Mohammed Alasmari, Mohammed Alharthi, Amal Alshaikh, Albaiyan Almasalami, Osama Althomali, and Abdullah Tawakul. "Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials." International Journal of Medicine in Developing Countries 10 (2026), 2920-2933. doi:10.24911/IJMDC.51-1785536046


MLA (The Modern Language Association) Style

Alzaydi, Roaa, Renad Almashyakhi, Hala Alduribi, Abdulrahman Alshayea, Nawaf Alharbi, Mohammed Alasmari, Mohammed Alharthi, Amal Alshaikh, Albaiyan Almasalami, Osama Althomali, and Abdullah Tawakul. "Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials." International Journal of Medicine in Developing Countries 10.9 (2026), 2920-2933. Print. doi:10.24911/IJMDC.51-1785536046


APA (American Psychological Association) Style

Alzaydi, R., Almashyakhi, . R., Alduribi, . H., Alshayea, . A., Alharbi, . N., Alasmari, . M., Alharthi, . M., Alshaikh, . A., Almasalami, . A., Althomali, . O. & Tawakul, . A. (2026) Middle meningeal artery embolization plus standard care for chronic or non acute subdural hematoma: an updated systematic review and meta-analysis of 6 randomized controlled trials. International Journal of Medicine in Developing Countries, 10 (9), 2920-2933. doi:10.24911/IJMDC.51-1785536046




Most Viewed Articles
Most Accessed Articles

  • Marginal adaptation of fixed prosthodontics
    Shahad Mohammed Halawani, Sahar Amer Al-Harbi
    IJMDC. 2017; 1(2): 78-84
    » Abstract » doi: 10.24911/IJMDC.1.2.7

  • Parasites in central nervous system
    Amal Ahmed Mohamed, Asmaa Mohamed Mansour
    IJMDC. 2017; 1(2): 72-77
    » Abstract » doi: 10.24911/IJMDC.1.2.6

  • Non-diabetic retinopathy: a case report
    Hassan F. Alkwikbi, Nabil Mamon Abdelfattah, Haithem Mamon Abdelfattah
    IJMDC. 2017; 1(1): 33-37
    » Abstract » doi: 10.24911/IJMDC.1.1.6

  • Vitamin D deficiency among high school female students in Riyadh
    Sahar Mohsen Aldhafeeri, Fatemah Ibraheem Alrawaji, Abrar Mubarak Algharbi, Alanoud Abdullah Alhessan, Ayat Sami Qabaja, Ghaleah Abdulaziz Alnassar, Ghaliah Ofayn Alsulami, Mashael Belal Alrubaian, Norah Abdulaziz Alhatim, Salehah Salih Alotaibi, Zahra Ali Alkhamees
    IJMDC. 2017; 1(1): 18-23
    » Abstract » doi: 10.24911/IJMDC.1.1.4

  • Prognosis of chronic complications of diabetes mellitus (DM) after multiple events of diabetic ketoacidosis (DKA)
    Baraa Faiez Rajab, Anwar Essa Alamrim, Ali Essa Alamri
    IJMDC. 2019; 3(5): 474-479
    » Abstract » doi: 10.24911/IJMDC.51-1546551993

    •
    Most Downloaded
    Top Downloaded Articles

  • Perception and attitude of medical students towards trauma and orthopedic teaching: a cross-sectional study
    Nawaf Hameed Almohammadi, Faisal Ali Almesned, Atif Omar Alhawsah, Sami Aoudah Alahmari, Madloul Jassim Alshammari, Hamad Ali Alkhunayfir
    IJMDC. 2019; 3(6): 503-508
    » Abstract » doi: 10.24911/IJMDC.51-1548706801

  • Anti-IL-17 markedly inhibited the in vitro granuloma induced by Schistosoma mansoni soluble egg antigen.
    Asmaa Ezz, Irene S. Gmail, Fatma Elzahraa H. Salem, Rabab Salama, Soad Nady
    IJMDC. 2018; 2(January 2018): 38-46
    » Abstract » doi: 10.24911/IJMDC.2.1.7

  • Vitamin D deficiency among high school female students in Riyadh
    Sahar Mohsen Aldhafeeri, Fatemah Ibraheem Alrawaji, Abrar Mubarak Algharbi, Alanoud Abdullah Alhessan, Ayat Sami Qabaja, Ghaleah Abdulaziz Alnassar, Ghaliah Ofayn Alsulami, Mashael Belal Alrubaian, Norah Abdulaziz Alhatim, Salehah Salih Alotaibi, Zahra Ali Alkhamees
    IJMDC. 2017; 1(1): 18-23
    » Abstract » doi: 10.24911/IJMDC.1.1.4

  • Antibiotic Resistance Crisis
    Nuha Saad Mobarki, Buthaina Abdullah Almerabi, Ahmad Hattan Hattan
    IJMDC. 2019; 3(6): 561-564
    » Abstract » doi: 10.24911/IJMDC.51-1549060699

  • Marginal adaptation of fixed prosthodontics
    Shahad Mohammed Halawani, Sahar Amer Al-Harbi
    IJMDC. 2017; 1(2): 78-84
    » Abstract » doi: 10.24911/IJMDC.1.2.7

    •
    Most Cited Articles
    Most Cited Articles

  • Antibiotic Resistance Crisis
    Nuha Saad Mobarki, Buthaina Abdullah Almerabi, Ahmad Hattan Hattan
    IJMDC. 2019; 3(6): 561-564
    » Abstract » doi: 10.24911/IJMDC.51-1549060699
    Cited : 34 times [Click to see citing articles]

  • Prevalence of depression, anxiety and stress among diabetes mellitus patients in Arar, Northern Saudi Arabia
    AMohammed Elamin Mukrim, Nujud Muteb D. Alshammari, Wurud Muteb D. Alshammari, Maali Subhi T. Alshammari, Yousef Nasif R. Alshammari, Abdulaziz Sael M. Alshammari, Maisa Hamad F. Alanazi, Abdulelah Abdulrhman F. Alzammam, Muharib Mana M. Alshammari, Slwa Khaled Abu Asyah, Aseel Jamal Alzuhayri, Mushref Saeid Alshammari
    IJMDC. 2019; 3(3): 229-233
    » Abstract » doi: 10.24911/IJMDC.51-1542576396
    Cited : 8 times [Click to see citing articles]

  • Knowledge, attitude, and practice of breast self-examination toward breast cancer among female students at King Saud University in Riyadh, Saudi Arabia
    Abdullah Nasser Alomair, Dania Ghazi Felemban, Mohannad Sami Felemban, Jameel Abdullah Awadain, Ammar Saud Altowairqi, Nawaf Fawzan Alfawzan, Fatimah Mohammed Almazayen, Abdulrahman Jalwi Korkoman, Nawaf Saad Alrusayyis
    IJMDC. 2020; 4(2): 429-434
    » Abstract » doi: 10.24911/IJMDC.51-1576668182
    Cited : 8 times [Click to see citing articles]

  • Population awareness about rheumatoid arthritis in Jazan region, Saudi Arabia
    Ahmad Ali Hazzazi, Mohssen Hassen Ageeli, Ahmed Ali Muyidi, Abdulaziz Mohammad Abulgasim, Abdullah Ahmad Yateemi, Nabil Alhakami
    IJMDC. 2020; 4(3): 668-675
    » Abstract » doi: 10.24911/IJMDC.51-1576010943
    Cited : 4 times [Click to see citing articles]

  • Prevalence and factors associated with depression among health care workers in National Guard Hospital in Riyadh, KSA
    Noor Mohammad AlFahhad
    IJMDC. 2018; 2(September 2018): 92-96
    » Abstract » doi: 10.24911/IJMDC.51-1526306040
    Cited : 4 times [Click to see citing articles]

  • Effect of inter-pregnancy interval on pregnancy outcome: a prospective study at Fayoum, Egypt
    Eman M. Mahfouz, Naglaa A. El-Sherbiny, Wafaa Y. Abdel Wahed, Nashwa S. Hamed
    IJMDC. 2018; 2(May 2018): 38-44
    » Abstract » doi: 10.24911/IJMDC.51-1520268317
    Cited : 4 times [Click to see citing articles]

  • Diabetic neuropathy in Saudi Arabia: a comprehensive review for further actions
    Mohammad Mater Aljohani, Amjad Taj Karam, Ayman Abdulaziz Alamri, Mohammed Hamed Manfaloti, Hussain Abbas Alnakhli, Hatem Ahmed Shaqroon
    IJMDC. 2020; 4(11): 2008-2013
    » Abstract » doi: 10.24911/IJMDC.51-1601343665
    Cited : 4 times [Click to see citing articles]

  • Public Awareness of coronary artery disease risk factors in Qassim, Saudi Arabia: a cross-sectional study
    Abdullah Muzil Albadrani, Saleh Sulaiman Al-Ajlan, Abdullah Saer E. Alharbi, Abdulelah Saud Alharbi, Saif Mohammed Radhi Alharbi
    IJMDC. 2020; 4(3): 593-599
    » Abstract » doi: 10.24911/IJMDC.51-1572217065
    Cited : 4 times [Click to see citing articles]

  • Ischemic stroke: prevalence of modifiable risk factors in the Saudi population
    Muhannad Noor Alharbi, Atheer Khalid Alharbi, Mousa Atqan Alamri, Abdulmalik Ayedh Saad Alharthi, Abdulrahman Moneer Alqerafi, Mohamed Noor Alharbi
    IJMDC. 2019; 3(7): 601-603
    » Abstract » doi: 10.24911/IJMDC.51-1548376707
    Cited : 3 times [Click to see citing articles]

  • Prevalence and risk factors for diabetic nephropathy in type 2 diabetic patients, Taif City, Saudi Arabia
    Basel Saad Alzahrani, Turki Hamdan Alzidani, Abdullah Mohammed Alturkistani, Hani Abozaid
    IJMDC. 2019; 3(2): 167-172
    » Abstract » doi: 10.24911/IJMDC.51-1541336905
    Cited : 3 times [Click to see citing articles]

  • Assessment of knowledge and awareness regarding thyroid disorders among Saudi people
    Assem Saleh Ali Almuzaini , Bayan ahmad I Alshareef , Sundos Hamoud O Alghamdi, Ayman Adnan Munshy, Abdulmajeed Khalid M. Aljarallah, Saud Abdulaziz A Salman, Khalid Saud Alroqi, Reem Dayel A Alkhaldi
    IJMDC. 2019; 3(12): 1070-1076
    » Abstract » doi: 10.24911/IJMDC.51-1568037206
    Cited : 3 times [Click to see citing articles]

  • Assessment of knowledge, attitude, and practice in relation to use of isotretinoin among Al-Madinah population, Saudi Arabia
    Amr Molla, Hassan Abdullah Alrizqi, Emtinan Mohammed Salem Alruhaili, Saad Abdullah Alrizqi, Arwa Musaad Alsubhi
    IJMDC. 2020; 4(1): 107-112
    » Abstract » doi: 10.24911/IJMDC.51-1571752077
    Cited : 3 times [Click to see citing articles]

  • Ethical considerations in doctors & pharmaceutical industries relationship: a narrative review
    Mohammed Saud Almasri, Yousef Rafat Bukhari, Bandar Saleh Alzuair, Mansour Khalid Almadi, Amro Khalid Bin Abdulrahman
    IJMDC. 2020; 4(1): 244-252
    » Abstract » doi: 10.24911/IJMDC.51-1572794591
    Cited : 3 times [Click to see citing articles]

  • Assessment of the knowledge of pregnant women regarding the effects of GDM on mothers and neonates at a Maternal and Children hospital in Najran, Saudi Arabia
    Amina Abdo Salhi, Medical Intern, Majed Saeed Alshahrani, Maram Mohammed Alyamin, Waad Ahmed Hamdi, Sarah Raja Alyami, Albatool Saleh Almagbool, Nujoud Hamad Almoqati, Seham Hamad Almoqati, Esra'a Amer Nasser Al-Saaed, Hessa Salem Al Habes, Batool Mubarak Abdullah Alwdei, Ahlam Yhya Saeed Alyami, Wesal Ahmed Alassiri
    IJMDC. 2019; 3(4): 370-375
    » Abstract » doi: 10.24911/IJMDC.51-1545817090
    Cited : 3 times [Click to see citing articles]

  • Awareness of the Saudi population about the role of the Emergency Rooms
    Zead Ibrahim A. Alhussain, Mohammed Ali A. Alghamdi, Rana Mohamed Ahmed, Abdullah Yahya Aldhban, Abdulrahman Ali Alghamdi, Naif Shalan J. Alalyani
    IJMDC. 2019; 3(11): 957-962
    » Abstract » doi: 10.24911/IJMDC.51-1568717752
    Cited : 3 times [Click to see citing articles]

    •

    About International Journal of Medicine in Developing Countries

    International Journal of Medicine in Developing Countries is a peer-reviewed, open-access international medical journal. Journal Title Internat ... Read more.



    For best results, please use Internet Explorer or Google Chrome.

    Contact Information

    Publisher: Waraqa Publishing House, Riyadh, Saudi Arabia



    Hosted by: Discover STM Publishing Ltd. 164 Moyville. Rathfarnham, Dublin, D16Y4E, Ireland.

    Hours:  M-F: 7:30am - 4:30pm 



    Emails:

    Journal Editorial Office:  contact@ijmdc.com

    All queries regarding the publishing or acceptance of the manuscript should be directed to the Journal Editorial Office at Riyadh, Saudi Arabia. 

    Hosting service is provided by Discover STM (Ireland):  contact@discoverpublish.com
    POLICIES & JOURNAL LINKS
    Author Login
    Reviewer Login
    Author LoginReviewer LoginAbout PublisherEditorial PoliciesEditorial Review PolicyPeer Review PolicyEditorial & Peer Review ProcessAuthor's Rights and ObligationsPublication Ethics and Publication Malpractice StatementConflict of Interest PolicyPlagiarism PolicyProtection of Research Participants (Statement On Human And Animal Rights)Corrections, Retractions & Expressions of ConcernSelf-Archiving PoliciesAdvertising PolicyLicense InformationCopyright Information