Observation
Some small, stable collections can be followed with examinations and repeat scans.
When monitoring may fitFor patients & families
Subdural hematoma.
A clearer path
to your next step.
Understand the diagnosis, explore treatment options, and connect with a specialist who can review your symptoms and scans.
An educational guide from Neurovascular Centers
Pasadena · Long Beach · Orange
A closer look: where the blood collects
Wled Wazni, MD
Neurologist & neurointerventionalist
Meet your specialistQuestions about an appointment?833-787-6539Monday–Friday, 8 am–5 pm Pacific
Start with your question
You don’t have to figure it out alone.
Choose the guide that fits where you are today.
We just received a diagnosis.
What a subdural hematoma is, and what acute or chronic means.
Understand the diagnosisWhat are the treatment options?
Understand observation, surgical drainage, and embolization.
Compare the optionsCould MMA embolization help?
Learn where it fits, including after drainage or a recurrence.
Learn about MMAEWe’re preparing for a visit.
A printable checklist of scans, records, medicines, and questions.
Get the visit checklistTaking a blood thinner? Read the medication guide and follow your treating team’s instructions.
Understand your options
Different treatments.
One individual care plan.
The right approach depends on symptoms, imaging, and how urgently pressure needs to be relieved.
Surgical drainage
Removing blood can relieve pressure on the brain. Worsening symptoms may require urgent surgery.
Understand drainageMMA embolization
For selected chronic collections, a catheter procedure targets the blood supply to the surrounding membranes.
Explore embolizationThese approaches may be used together. MMA embolization does not replace emergency drainage when immediate pressure relief is needed. Read the full treatment guide →
When the bleed is chronic
A small catheter. A different way to treat a chronic collection.
Middle meningeal artery embolization—MMAE—uses a small catheter to reach an artery supplying the membranes around a chronic subdural hematoma.
By blocking that supply, it can help the collection resolve over time and lower the risk of needing another intervention.
A small entry point
The specialist guides a catheter through an artery in the wrist or groin using X-ray imaging.
A focused treatment
Embolic material blocks selected branches of the middle meningeal artery supplying the abnormal membranes.
A plan for healing
The collection can shrink gradually. Follow-up scans and clinical examinations track progress.
MMAE has risks, including stroke. It does not replace urgent surgery when pressure must be relieved immediately. Benefits, risks & candidacy →
The evidence matters
Evidence you can understand.
Randomized trials and professional guidance now support an important role for MMAE in selected patients with chronic subdural hematoma.
Recommended alongside drainage
Level A evidence supports adjunctive MMAE to reduce recurrence requiring another intervention, balanced against procedural risk.
Read the recommendation ↗Fewer repeat operations
Reoperation for recurrence or progression at 90 days: MMAE plus surgery compared with surgery alone.
400 randomized patients. Procedure-related serious adverse events occurred in 2.0% of the MMAE group, including two disabling strokes.
Read the trial ↗Your symptoms. Your plan.
The strongest recommendation is for MMAE with surgery. Standalone treatment is reasonable in selected circumstances and requires specialist assessment.
See the evidence in context →Study results describe groups, not a prediction for any one patient. Trials used different populations and endpoints; not every trial met its primary efficacy endpoint. Compare EMBOLISE, STEM, and MAGIC-MT.
Specialist care, close to home
Your scans. Your questions. A plan that makes sense.
Dr. Wled Wazni · Neurologist & neurointerventionalist
Dr. Wazni brings training in vascular neurology, neurocritical care, and neurointervention to the discussion. Review your diagnosis, ask about treatment choices, or seek a second opinion at Neurovascular Centers.
- Review your symptoms and available imaging
- Discuss the benefits and risks of your options
- Plan treatment or follow-up with your care team
Pasadena / Long Beach / Orange
The complete patient guide
The full guide, whenever you need it.
Understand the diagnosis
Explore treatment
Look a little deeper
Common questions
A few questions you may be asking.
Start with the essentials. Your care team can help apply them to your individual situation.
Read the full FAQ →Is a subdural hematoma the same as a stroke?
A subdural hematoma is blood collected outside the brain, beneath its outer protective covering. It differs from an ischemic stroke, which is caused by a blocked artery, and an intracerebral hemorrhage, which is bleeding inside brain tissue. Symptoms can overlap and require urgent assessment.
Does every subdural hematoma need surgery?
No. Some small, stable collections can be monitored with examinations and repeat imaging. Others require drainage, MMA embolization, or both. Significant pressure on the brain or worsening neurologic symptoms can require emergency surgery.
Can MMA embolization replace surgery?
For some carefully selected patients with chronic subdural hematoma, MMA embolization can be used without drainage. It is also used alongside surgery to reduce recurrence. It does not immediately remove the blood collection and should not delay urgent decompression.
Can a subdural hematoma come back?
Yes. Chronic subdural hematomas can recur after treatment. Follow-up imaging matters even when symptoms improve. MMA embolization can lower the chance of recurrence in appropriate patients, but it cannot eliminate that risk.
How do I arrange a consultation?
Contact Neurovascular Centers at 833-787-6539 or use the appointment request link. Bring your CT or MRI images, reports, medication list, and hospital records. For new weakness, trouble speaking, a seizure, or worsening drowsiness, call 911 instead of waiting for an appointment.