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What is Chronic Subdural Hematoma?
What is Middle Meningeal Artery Embolization (MMAE) Technique?
Dehradun, July 2025: Shri Mahant Indiresh Hospital, Dehradun has achieved another remarkable achievement in the direction of medical science. The hospital treated the complex condition of blood clot in the brain, Chronic Subdural Hematoma, using the latest technology, Middle Meningeal Artery Embolization (MMAE). Successful procedures were performed on two patients with this latest technology under the leadership of Professor Dr. Mahesh Ramola, Head of Neurosurgery Department of Shri Mahant Indiresh Hospital. This procedure is safer and minimally invasive than traditional surgery. Shri Mahant Devendra Das Ji Maharaj, Chairman of Shri Mahant Indiresh Hospital, congratulated and wished the team of doctors on this success.
What is Chronic Subdural Hematoma?
Chronic subdural hematoma (CSDH) is a serious but common neurosurgical problem involving the brain that often requires brain surgery to remove a part of the skull bone. The number of cases is rising as the number of people living in the elderly increases. The condition usually develops gradually after a minor head injury, especially in the elderly. It causes blood to collect on the brain, which builds up pressure over time. Symptoms may include headache, nausea or vomiting, weakness in the arms and legs, difficulty walking, forgetfulness, irritability, lethargy, difficulty speaking, and sometimes loss of consciousness or loss of consciousness. Traditional treatment for chronic subdural hematoma involves clearing the hematoma by removing a piece of the skull bone. But it has been observed that in 30-50% of cases, the treatment fails and there is a possibility of re-bleeding in the brain, re-formation of blood clots, and the need for repeated operations. This can lead to deterioration of the patient’s condition, increased weakness in the arms or legs, severe disability, or even a risk to life. Elderly people or patients taking blood thinners are at a higher risk of re-bleeding.
What is MMAE technique?
MMAE is an ultra modern, minimally invasive procedure, in which no large incision is made in the skull or any other part of the body, nor is any stitching required. This process is done through a fine catheter or needle. In this, medicine is injected through a thin catheter into the arteries (Middle Meningeal Artery) which cause bleeding in this disease. This procedure takes less time and there is less chance of bleeding or blood clotting in the brain again. This procedure is proving to be a boon especially for elderly patients and high-risk patients. This very modern medical method is considered safe and effective. In February 2025, NEJM (New England Journal of Medicine), the world’s most prestigious and highest impact factor medical journal, published a multicenter randomized controlled trial, in which the positive results of MMAE have been certified. After treatment with this technique, the patient has to stay in the hospital for a shorter period of time than normal surgery, and recovery is also faster.
Why is this achievement special?
The facility of MMAE is routinely available in only a few selected medical centers in India, where both endovascular and neurosurgical facilities are available together.
Shri Mahant Indiresh Hospital has now joined the select few prestigious institutions in the country where this state-of-the-art medical facility is available.
This will enable patients of Uttarakhand and nearby areas to avail the benefits of state-of-the-art medical treatment, which was till now mostly limited to big metro cities.
Professor Dr. Mahesh Ramola said that
“Along with traditional methods of surgery, our team has now adopted science-based new techniques so that patients can get better treatment at less risk. Through MMAE, we can also help those patients who are not fit for operation.”
The following team of doctors and staff were actively involved in this process:
Dr. Mahesh Ramola, Dr. Shiv Karan Gill, Ritish Garg, Dr. Nishit Govil, Dr. Hariom Khandelwal, Dr. Divij Dhyani, Anuj Rana, Bhuvan, Vipen, Manish Bhatt, Mukul and Ankit. Due to their dedication and collective efforts, this complex process could be completed successfully.” Dr. Pankaj Arora, senior neurosurgeon and Dr. Vibhu Shankar also provided special support.
