How researchers in Winnipeg are helping change brain bleed treatment

Made in Manitoba research could transform the way doctors treat chronic brain bleeds.

New research in Winnipeg is helping improve how chronic brain bleeds are treated by making them safer and less invasive.

Dr. Jai Shankar, a neuro interventional radiologist at Health Sciences Centre and professor of radiology at the University of Manitoba, highlighted a study that researchers in Winnipeg worked on to treat chronic subdural hematoma (CSDH).

“It’s a brain bleed that happens on the surface of the brain. Happens more (commonly) in men, three times more common in men than women and the average age of these patients is 72,” said Shankar.

“When it happens, it compresses the brain and causes stroke-like symptoms like weakness of hands, legs, visual problems or speech problems that could be either temporary or permanent, depending on how big the bleed is.”

Normal treatment for CSDH is open brain surgery and removing the clot in the brain.

Shankar said there’s around a one in four chance of the brain bleed reoccurring when only this procedure is performed.

Now, following a new randomized trial of 186 patients, researchers are recommending performing a secondary procedure called EMMA – embolization of the middle meningeal artery.

EMMA is done by inserting a tiny wire through either the top of the leg or wrist and moving it to the surface of the brain. The wire is used to close off the new blood vessels that are forming, greatly reducing the chance of another clot from forming.

“What we found from our own study, which was initiated here in Winnipeg and ran across nine different sites across Canada, is that when we do this treatment after surgical drainage, then the rate of recurrence of the bleed comes down from 28 per cent to four per cent.”

He notes EMMA has been around for the last 10 years or so, but it wasn’t a procedure that was done often.

“What we wanted to know was whether this treatment can be applied globally to every single patient or not.”

Shankar said the findings will help improve medical care in Manitoba, Canada, and around the world.

He said when patients had to return for another drainage treatment because the hematoma returned, it was a surgery that became even more complicated.

“That’s the biggest advantage here is that these patients do not need to come back as often as they did in the past and so this will improve patient care, reduce the health-care costs that we incur for these patients, not only just here, but globally.”

The study was posted in the Journal of the American Medical Association on April 30, 2026.