Breakthrough Treatment at Marcus Neuroscience Institute Helps Older Adults Heal from Brain Bleeds

A sudden fall, a confusing moment, or an unexpected headache can be unsettling, especially for older adults. While sometimes these are minor issues, they can also be signs of something more serious, like a brain bleed known as a subdural hematoma. Understanding this condition and the latest treatment options can make a critical difference.

A subdural hematoma occurs when blood collects between the brain's surface and its outer covering, called the dura. This is often caused by a head injury, which can be as mild as a small bump. The veins in this area are fragile, especially in older adults, and can tear easily, leading to a slow bleed.

For many years, the primary treatment for a significant subdural hematoma was open brain surgery to drain the blood. While effective, this carries risks and can require a long recovery. For chronic cases, where the bleed recurs, patients might face multiple surgeries, compounding the risks and emotional toll.

A Game-Changing Minimally Invasive Procedure

Brian Snelling, M.D., director of cerebrovascular and endovascular neurosurgery at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health.

 

Medical advancements are providing new hope. One of the most significant breakthroughs is a procedure called middle meningeal artery (MMA) embolization. This minimally invasive technique is revolutionizing how doctors treat and prevent the recurrence of chronic subdural hematomas.

At the forefront of this innovation is Brian Snelling, M.D., director of cerebrovascular and endovascular neurosurgery at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health. Dr. Snelling and his team have performed more than 200 MMA embolizations, making them one of the most experienced teams in the country.

“This approach has been a game-changer for many of our patients, especially older adults on blood thinners,” says Dr. Snelling. “It allows us to treat the problem safely while helping patients recover faster.”

How Does MMA Embolization Work?

As blood accumulates during subdural hematoma, it puts pressure on the brain. This pressure can cause a range of symptoms, including:

• Headaches

• Confusion or memory problems

• Drowsiness or lethargy

• Dizziness or loss of balance

• Nausea or vomiting

• Weakness on one side of the body

Instead of opening the skull, MMA embolization is performed through a tiny incision, usually in the patient’s wrist. A neurosurgeon guides a microcatheter through blood vessels up to the middle meningeal artery, which is the main artery supplying blood to the brain's covering.

Once in position, the surgeon injects a special material that blocks off the bleeding vessel. This stops the flow of blood into the subdural space and allows the existing hematoma to be absorbed by the body over time. The entire process significantly lowers the risk of the bleed returning.

The benefits of this approach are substantial. Many patients can go home the same day. Because it avoids the trauma of open surgery, it is a much safer option for older adults and individuals with fragile health.

A Safer Path for Patients on Blood Thinners

MMA embolization offers a particular advantage for a growing number of people who take blood thinners for conditions like heart disease, atrial fibrillation, or a previous stroke. These medications are vital for preventing life-threatening clots but increase the risk of bleeding complications from falls or injuries.

Traditionally, these patients would need to stop their blood thinners before undergoing brain surgery, leaving them vulnerable to other medical events. With MMA embolization, Dr. Snelling’s method allows medications to be restarted much earlier, protecting them from other serious health risks while their brain heals.

More Than Just One Innovation

The commitment to pioneering care extends beyond treating subdural hematomas. The team at Marcus Neuroscience Institute also specializes in other complex neurological conditions.

For instance, patients with idiopathic intracranial hypertension (IIH), a condition marked by increased pressure around the brain that causes severe headaches and vision problems, can find relief through venous sinus stenting. This procedure helps restore normal brain pressure and dramatically improves a person's quality of life.

The Institute also participates in multiple national stroke trials. This involvement gives patients in the community early access to promising investigational therapies that are shaping the future of stroke care worldwide.

Compassion at the Core of Care

Advanced technology and innovative procedures are only one part of the equation. Facing a brain emergency is a frightening experience for both patients and their families. That’s why a compassionate, patient-centered approach is essential.

Dr. Snelling emphasizes that human connection is central to his practice. “We know how frightening it is when a loved one is facing a brain emergency,” he says. “I treat every patient as if he or she was a member of my own family — and I want families to feel informed, supported, and reassured every step of the way.”

This philosophy is embedded in the Institute’s culture. With a 24/7 neuro-emergency response team, state-of-the-art imaging, and a deep well of expertise, the focus remains on delivering not just lifesaving care, but also the peace of mind that families need most during a crisis.