Abstract
BACKGROUND: Chronic subdural hematoma (cSDH) is a common neurosurgical pathology causing significant morbidity and mortality, yet optimal management and intervention remains controversial. METHODS: We describe embolization of the middle meningeal artery (MMA) and placement of subdural evacuating port systems (SEPS) by a dual trained open and endovascular neurosurgeon. Both procedures are done in sequence in the interventional radiology suite, and real time radiographic results are demonstrable with Xper-CT. CONCLUSIONS: MMA Embolization followed by evacuation of cSDH with a SEPS is a valuable strategy to mitigate perioperative risk factors and patient comorbidities, through a minimally invasive evacuation with subsequent embolization minimizing recurrence.