Made-in-Manitoba research transforms brain surgery

A minimally invasive procedure called EMMA significantly reduces the risk of chronic subdural hematoma (CSDH) recurrence, according to research led by University of Manitoba professor Dr. Jai Shankar. A randomized trial of 186 patients found that those receiving EMMA alongside surgery had a 4.3% recurrence rate, compared to 28% for surgery alone, according to Shankar.

CSDH, a common adult neurosurgical condition, occurs on the brain’s surface and can cause stroke-like symptoms. Previously, treatment required open brain surgery, but EMMA now allows patients to undergo the procedure as an outpatient, according to the study.

What is EMMA and how does it work?

EMMA, or embolization of the middle meningeal artery, reduces blood flow to the brain’s outer covering to prevent re-bleeding after CSDH surgery. The procedure involves inserting a wire through the leg or wrist to target new blood vessels, limiting recurrence risk, as described by Shankar.

Why this development matters

The study, published in the Journal of the American Medical Association (JAMA) on April 30, 2026, highlights a potential shift in global treatment practices for CSDH. Shankar emphasized that EMMA reduces the need for repeat surgeries, shortens hospital stays, and improves patient quality of life.

What may happen next?

Health systems may adopt EMMA as a standard post-surgery treatment for CSDH, depending on further validation. Analysts suggest its outpatient nature could ease healthcare resource demands, though widespread implementation would require training for neurointerventional radiologists.

The research was conducted using Manitoba-based resources, with support from the Paul Albrechtsen Interventional Radiology Suites. Shankar credited Manitoba patients for enabling the study’s success, stating that their participation advanced treatment possibilities for CSDH globally.

Frequently Asked Questions

What is EMMA? EMMA stands for embolization of the middle meningeal artery, a procedure that reduces blood flow to the brain’s outer covering to prevent re-bleeding after CSDH surgery.

What were the trial results? Patients receiving EMMA alongside surgery had a 4.3% recurrence rate, compared to 28% for those treated with surgery alone.

Where was the research published? The findings were published in the Journal of the American Medical Association (JAMA) on April 30, 2026.

How might this advancement impact healthcare systems in the coming years?