Chronic Subdural Hematoma Treatment With Intra-Arterial Bevacizumab Injection

Exclusion Criteria

• •Pregnant, breastfeeding, or unwilling to practice contraception during participation in the study.
• •Patients with concomitant intracranial pathology other than subdural hematoma (e.g., intracranial malignancy).
• •Patients with known hypersensitivity to bevacizumab.
• •Patients with radiographic evidence of mass effect.
• •Patients have focal neurological deficits attributed to subdural hematoma.
• •Patient had craniotomy or burr hole operative procedures performed in preceding two weeks prior to onset of subdural hematoma.
• •Secondary causes apart from trauma for the chronic subdural hematoma, such as underlying vascular abnormality or tumor.
• •Emergent surgical evacuation is required for the patient.
• •Non-convexity chronic subdural hematoma, as the middle meningeal artery will not supply this area.
• •Coagulation abnormalities, including platelet count \<100,000 and/or international normalized ratio of \<1.5 despite attempts for correction.
• •Patients with known contraindications for angiography. Patients with contrast allergy will be premedicated with diphenhydramine and steroids.
• •Patient has known active systemic infection or sepsis.
• •Patient has contradiction to anesthetic agents used for conscious sedation/monitored anesthesia care (MAC).
• •Patient has life expectancy of less than six months due to comorbid terminal conditions.
• •Patient has a premorbid modified Rankin score (mRS) of 5 or greater.
• •Concurrent participation in another research protocol for investigation of an experimental therapy.