• Sinan Sağıroğlu, Cansın Şirin, Ali Çağlar Turgut, Canberk Tomruk, Ayça Tuzcu, Ersen Ertekin, Yiğit Uyanıkgil, and Mehmet Turgut.
• Department of Neurosurgery, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
• World Neurosurg. 2024 Sep 1; 189: e272e286e272-e286.

IntroductionChronic subdural hematoma (cSDH), a condition that develops over time, is characterized by inflammation, angiogenesis, and membrane development. As the population's average age increases, the incidence of cSDH is expected to grow. While surgery is the primary treatment technique, medicinal therapy options are being explored for high-risk patients. Currently, the most effective therapy combination is dexamethasone (Dex) and atorvastatin (Ato); however, it is associated with an increased risk of mortality. This study explored the effects of bevacizumab (Bev), a vascular endothelial growth factor antagonist, on cSDH.Materials And MethodsNinety-five rats were divided into four groups (n = 18): sham, control hematoma, Dex-Ato, and Bev. Two separate autologous blood injections into the subdural space were used as the model. Weight was monitored for all rats to assess changes in their overall health. The control group was given i.p. saline, the Dex-Ato treatment was given by gavage, and the Bev treatment was given i.p. On seventh, 14th and 21st days six rats from each group were sacrificed and analyzed, while 23 rats were excluded from the experiment.ResultsThe maximum immunological response to cSDH was observed on day 14. Hematoma volume decreased over time in all groups. Dex-Ato and Bev were both found effective, while Dex-Ato caused weight loss.ConclusionBev had similar effects to the Dex-Ato group and was well tolerated by rats. Given that cSDH is a disease of the elderly and vulnerable populations, Bev may be a viable alternative that can shed light on the disease's etiology for future research.Copyright © 2024 Elsevier Inc. All rights reserved.

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