Recurrent Subdural and Epidural Hematomas: A Case Report of Complications Following Craniotomy and Middle Meningeal Artery Embolization.

This report presents a 76-year-old male patient who developed indolent right-sided upper and lower extremity weakness and low back pain following a fall that resulted in no trauma and was not prompted by syncope or vertigo. Imaging revealed a chronic subdural hematoma (cSDH) with midline shift, for which the patient underwent craniotomy and middle meningeal artery (MMA) embolization. Despite initial intervention, the patient experienced rare and severe complications, including the recurrence of a subdural hematoma (SDH), the development of an epidural hematoma, and frontal lobe herniation.  The significance of this report lies in its complications following MMA embolization, a treatment, though novel, generally considered safe and effective for cSDH. This case highlights the potential for unexpected and severe, life-threatening outcomes in certain patients, emphasizing the need for physicians to remain vigilant for such complications. By exploring these rare occurrences, this report contributes to the evolving understanding of embolization risks and the need for structuring treatment strategies tailored to patients based on vulnerability.