BACKGROUND Middle meningeal artery (MMA) embolization has been increasingly applied in adult populations for the treatment of chronic subdural hematomas (cSDH). There is a paucity of literature on the indications, safety, and outcomes of MMA embolization in the pediatric population. SUMMARY A systematic literature review on pediatric patients undergoing MMA embolization was performed. We also report the case of successful bilateral MMA embolization for persistent subdural hematomas following resection of a juvenile pilocytic astrocytoma. Persistent bilateral subdural hematomas following resection of a large brain tumor resolved following MMA embolization in a 13-year-old male. Indications for MMA embolization in the pediatric literature included cSDH (6/13, 46.2%), treatment or preoperative embolization of arteriovenous fistula or arteriovenous malformation (3/13, 23.1%), preoperative embolization for tumor resection (1/13, 7.7%), or treatment of acute epidural hematoma (1/13, 7.7%). Embolic agents included microspheres or microparticles (2/13, 15.4%), Onyx (3/13, 23.1%), NBCA (3/13, 23.1%), or coils (4/13, 30.8%). KEY MESSAGES Whereas MMA embolization has primarily been applied in the adult population for subdural hematoma in the setting of cardiac disease and anticoagulant use, we present a novel application of MMA embolization in the management of persistent subdural hematoma following resection of a large space-occupying lesion. Systematic review of MMA embolization in pediatric patients currently shows efficacy; multi-institutional study is warranted to further refine indications, timing, and safety of the procedure.

中文翻译：

---

儿科患者的脑膜中动脉栓塞。

背景脑膜中动脉（MMA）栓塞已越来越多地应用于成年人群，用于治疗慢性硬膜下血肿（cSDH）。关于儿科人群 MMA 栓塞的适应症、安全性和结果的文献很少。摘要 对接受 MMA 栓塞的儿科患者进行了系统的文献综述。我们还报告了幼年毛细胞星形细胞瘤切除术后持续性硬膜下血肿成功双侧 MMA 栓塞的病例。一名 13 岁男性在 MMA 栓塞后切除了一个大的脑肿瘤后，持续性双侧硬膜下血肿得到缓解。儿科文献中MMA栓塞的指征包括cSDH（6/13，46.2%）、动静脉瘘或动静脉畸形的治疗或术前栓塞（3/13，23.1%）、肿瘤切除术前栓塞（1/13，7.7%） ），或治疗急性硬膜外血肿（1/13，7.7%）。栓塞剂包括微球或微粒（2/13，15.4%）、Onyx（3/13，23.1%）、NBCA（3/13，23.1%）或线圈（4/13，30.8%）。关键信息 虽然 MMA 栓塞主要应用于成人心脏病和抗凝药物治疗中的硬膜下血肿，但我们提出了 MMA 栓塞在大占位性病变切除后持续性硬膜下血肿治疗中的新应用。目前对儿科患者 MMA 栓塞的系统评价显示出疗效；有必要进行多机构研究，以进一步完善手术的适应症、时机和安全性。