OBJECTIVE Chronic subdural hematomas (cSDHs) are increasingly common in aging populations, driven by the rising use of anticoagulant and antiplatelet therapies. Middle meningeal artery embolization (MMAE) is a promising minimally invasive treatment. This study projects the future US incidence of cSDH through 2050 and estimates MMAE demand based on hematoma size criteria. METHODS The authors utilized data from the National Inpatient Sample from 2016 to 2019 to calculate age-specific incidence rates of cSDH. Institutional CT scans of the head from a level I comprehensive trauma center were analyzed to determine the distribution of cSDH sizes and MMAE eligibility thresholds (5, 8, 10, and 15 mm). Population projections were obtained from the 2023 datasets of the US Census Bureau. RESULTS Among 531 institutional cSDH patients, the mean hematoma thickness was 13.0 ± 13.3 mm, with 75.0% exceeding 5 mm, 56.3% exceeding 8 mm, and 14.3% exceeding 15 mm. Using the > 8-mm eligibility threshold, the projected MMAE population increases from 39,294 patients in 2022 to 44,596 by 2050 (13.5% increase, p 5-mm threshold is applied, projections rise from 52,338 in 2022 to 59,401 in 2050 (p 15-mm threshold yields a smaller but still substantial cohort, increasing from 7594 to 8618 over the same period (p < 0.0001). Total cSDH cases are expected to grow from 69,794 in 2022 to 79,212 in 2050. CONCLUSIONS The projected increase in cSDH and the corresponding rise in MMAE-eligible patients signify a substantial emerging public health challenge. Anticipating a 13.5% growth in incidence by 2050, these findings emphasize the urgent need for proactive healthcare planning and resource allocation to accommodate the escalating demand for specialized interventions like MMAE.
Gajjar et al. (2026) studied this question.