Abstract
Chronic subdural hematoma (CSDH) is a common neurological disease that involves the collection of blood products in the subdural space. The progression of CSDH is an angiogenic and inflammatory process, but the multifactorial mechanisms underlying CSDH are still not fully understood. We aimed to identify one or more factors that may play an important role in the development of CSDH. We enrolled 83 patients with CSDH, including 17 postoperative patients, and analyzed 20 markers in the hematoma fluid and peripheral blood of each patient. Overall differential gene expression was examined to identify the representative markers. The concentration of MMP-8 was significantly lower in the postoperative group than in the preoperative group. The concentration of MMP-9 was significantly higher in the postoperative group than in the preoperative group. These findings indicate that MMP-8 and MMP-9 may play important roles in the pathophysiology of CSDH. Understanding the pathways associated with CSDH may provide insights for improving disease outcomes.
Highlights
Chronic subdural hematoma (CSDH) is a common neurological disease that involves the collection of blood products in the subdural space
Our analysis indicated that vascular endothelial growth factor (VEGF), platelet-derived growth factor-BB (PDGF-BB), TNF-alpha, matrix metallopeptidase 9 (MMP-9), IL-6, CCL2, IL-1 alpha, MMP-1, MMP-8, and IL-8 were Differentially Expressed Gene (DEG) between the hematoma fluid and the peripheral blood before surgery
Our findings indicated that the concentrations of most of the cytokines evaluated changed in the hematoma fluid, indicating that they may be involved in CSDH formation
Summary
Chronic subdural hematoma (CSDH) is a common neurological disease that involves the collection of blood products in the subdural space. It has an indolent course of progression, usually spanning more than 3 weeks [1,2]. The reported incidence of CSDH ranges from 1.72 to 20.6 per 100,000 persons per year; for those aged 70 years or older, the incidence is estimated to be 58 per 100,000 [2,3]. Surgery is the first choice of treatment for CSDH with significant symptoms, which may involve burr-hole drainage (BHD), twist-drill craniotomy (TDC), or mini-craniotomy [3]. One study reported that atorvastatin combined with low-dose dexamethasone may play a significant role in the treatment of CSDH [4]
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