BURR-MMA

• Research type

  Research Study

• Full title

  A Prospective Pilot Feasibility Study of Intra-operative Middle Meningeal Artery Coagulation During Burr-Hole Surgery for Chronic Subdural Haematoma

• IRAS ID

  365225

• Contact name

  Patrick Grover

• Contact email

  p.grover@nhs.net

• Sponsor organisation

  University College London Hospitals NHS Trust

• Duration of Study in the UK

  1 years, 4 months, 1 days

• Research summary

  
  Chronic subdural haematoma (cSDH) is a common condition in older adults where blood slowly collects on the surface of the brain, often after a minor head injury. It can cause headaches, confusion, problems with walking, or weakness. The usual treatment is burr-hole surgery, in which one or two small openings are made in the skull to drain the blood. Although this is generally effective, about 1 in 10 patients experience recurrence and may require further treatment.

  Research suggests that recurrence may be linked to small branches of an artery inside the skull called the middle meningeal artery (MMA), which may continue to supply the blood collection. A separate radiology procedure to block this artery can reduce recurrence, but this requires additional specialist resources and is not widely available across the NHS.

  This study will explore whether a simpler approach can be delivered during standard burr-hole surgery. Using CT-based imaging and surgical navigation (similar to a GPS system), the surgeon may adjust the position of the burr hole to allow sealing of small MMA branches using standard surgical techniques. No additional incisions are made, and if the artery cannot be clearly identified, the operation will proceed as standard.

  This is a pilot feasibility study. Its purpose is to assess whether this technique can be delivered safely and practically within routine NHS care, rather than to prove that it improves outcomes. Around 20–30 patients will take part at a single hospital.

  The study will assess recruitment, safety, integration into surgical workflow, and follow-up processes. The results will inform whether a larger multicentre study should be undertaken.

  Participation is voluntary and will not affect standard care.

• REC name

  East of England - Essex Research Ethics Committee

• REC reference

  26/EE/0105

• Date of REC Opinion

  2 Jun 2026

• REC opinion

  Further Information Favourable Opinion