OBJECTIVE: To explore the feasibility of color Doppler ultrasound (CDUS) in detecting the middle meningeal artery (MMA) and evaluate the clinical application of this method in chronic subdural hematoma (CSDH). METHODS: This study collected clinical data from 100 patients with CSDH who were admitted to our hospital between January 2023 and March 2024. Among these patients, 87 underwent drilling and drainage surgery. Postoperative follow-up categorized patients into a recurrence group and a nonrecurrence group. Additionally, 80 healthy volunteers and 60 patients with acute subdural hematoma were selected as the control group. Using CDUS technology, the MMA was assessed through the infratemporal fossa in the half-mouth position to obtain peak systolic flow velocity (PSV), end diastolic flow velocity, and resistance index (RI). Comparisons were conducted between the study group and the control group, as well as between the recurrence and nonrecurrence groups to evaluate hemodynamic differences. Multivariate logistic regression analysis was employed to identify risk factors for postoperative recurrence in patients with CSDH. Receiver operating characteristic curves were generated to assess the sensitivity and specificity of MMA hemodynamic parameters in predicting postoperative recurrence of CSDH. RESULTS: The MMA visualization rates for the CSDH group, healthy volunteer group, and acute subdural hematoma group were 84.43% (103/122), 85.00% (136/160), and 83.33% (70/84), respectively. Multivariate logistic regression analysis indicated that bilateral hematoma, increased PSV, and decreased RI were independent risk factors for the recurrence of CSDH following drilling and drainage (P <
0.05). The maximum Youden index was achieved when the PSV predictive value was 30.85 cm/s and the RI predictive value was 0.78. CONCLUSIONS: Utilizing CDUS in a half-open mouth position is a feasible method for evaluating extracranial MMA. Monitoring hemodynamic changes in the MMA of patients with CSDH postsurgery holds significant value in indicating the potential for postoperative recurrence.