A novel rat model of chronic subdural hematoma: Induction of inflammation and angiogenesis in the subdural space mimicking human-like features of progressively expanding hematoma

2021 ◽  
Vol 172 ◽  
pp. 108-119
Author(s):  
Xin Xu ◽  
Dong Wang ◽  
Zhenying Han ◽  
Bo Wang ◽  
Weiwei Gao ◽  
...  
Keyword(s):  
Rat Model ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Subdural Space

Cerebrospinal fluid leakage into the subdural space: possible influence on the pathogenesis and recurrence frequency of chronic subdural hematoma and subdural hygroma

2008 ◽  
Vol 108 (2) ◽  
pp. 275-280 ◽  
Author(s):  
Rudolf A. Kristof ◽  
Jochen M. Grimm ◽  
Birgit Stoffel-Wagner
Keyword(s):  
Cerebrospinal Fluid ◽  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Postoperative Recurrence ◽  
Cerebrospinal Fluid Leakage ◽  
Subdural Space ◽  
Subdural Hygroma ◽  
Fluid Leakage ◽  
Csf Leakage

Object The purpose of this study was to clarify whether cerebrospinal fluid (CSF) leakage into the subdural space is involved in the genesis of chronic subdural hematoma (CSDH) and subdural hygroma (SH) and to clarify whether this leakage of CSF into the subdural space influences the postoperative recurrence rate of CSDH and SH. Methods In this prospective observational study, 75 cases involving patients treated surgically for CSDH (67 patients) or SH (8 patients) were evaluated with respect to clinical and radiological findings at presentation, the content of β -trace protein (β TP) in the subdural fluid (βTPSF) and serum (βTPSER), and the CSDH/SH recurrence rate. The βTPSF was considered to indicate an admixture of CSF to the subdural fluid if βTPSF/βTPSER > 2. Results The median β TPSF level for the whole patient group was 4.29 mg/L (range 0.33–51 mg/L). Cerebrospinal fluid leakage, as indicated by βTPSF/βTPSER > 2, was found to be present in 93% of the patients with CSDH and in 100% of the patients with SH (p = 0.724). In patients who later had to undergo repeated surgery for recurrence of CSDH/SH, the βTPSF concentrations (median 6.69 mg/L, range 0.59–51 mg/L) were significantly higher (p = 0.04) than in patients not requiring reoperation (median 4.12 mg/L, range 0.33–26.8 mg/L). Conclusions As indicated by the presence of βTP in the subdural fluid, CSF leakage into the subdural space is present in the vast majority of patients with CSDH and SH. This leakage could be involved in the pathogenesis of CSDH and SH. Patients who experience recurrences of CSDH and SH have significantly higher concentrations of βTPSF at initial presentation than patients not requiring reoperation for recurrence. These findings are presented in the literature for the first time and have to be confirmed and expanded upon by further studies.

A rat model of chronic subdural hematoma: Insight into mechanisms of revascularization and inflammation

2015 ◽  
Vol 1625 ◽  
pp. 84-96 ◽  
Author(s):  
Wei Quan ◽  
Zhifei Zhang ◽  
Qilong Tian ◽  
Xiaolong Wen ◽  
Peng Yu ◽  
...  
Keyword(s):  
Rat Model ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Insight Into

Production of clinical form of chronic subdural hematoma in experimental animals

1972 ◽  
Vol 37 (5) ◽  
pp. 552-561 ◽  
Author(s):  
Satoru Watanabe ◽  
Hironobu Shimada ◽  
Shozo Ishii
Keyword(s):  
Cerebrospinal Fluid ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Subdural Space ◽  
Clinical Form ◽  
Content Type ◽  
Experimental Animals ◽  
Fine Print

✓ A method for producing a clinical form of experimental chronic subdural hematoma is reported. When blood is mixed with cerebrospinal fluid and incubated, a peculiar clot is formed which, when inoculated into the subdural space of dogs or monkeys, grows gradually. Histologically the capsule of the hematoma is comparable to that seen in human chronic subdural hematoma. In some animals progressive hemiparesis develops.

scholarly journals Atorvastatin combined with dexamethasone promote hematoma absorption in an optimized rat model of chronic subdural hematoma

Aging ◽  
2021 ◽  
Author(s):  
Dong Wang ◽  
Yueshan Fan ◽  
Jun Ma ◽  
Chuang Gao ◽  
Xuanhui Liu ◽  
...  
Keyword(s):  
Rat Model ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma

scholarly journals Endoscopic evacuation of septated chronic subdural hemorrhage – Technical considerations, results, and outcome

2022 ◽  
Vol 13 ◽  
pp. 8
Author(s):  
Harnarayan Singh ◽  
Rana Patir ◽  
Sandeep Vaishya ◽  
Rahul Miglani ◽  
Anurag Gupta ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Subdural Hemorrhage ◽  
Subdural Space ◽  
Subdural Bleeding ◽  
Endoscopic Evacuation ◽  
Clinically Significant ◽  
Burr Holes

Background: Chronic subdural hematoma (cSDH) is a common entity in the elderly. Homogeneous or well-liquefied CSDH has a standard line of treatment through burr hole and irrigation. However, the management of septated chronic subdural hematoma (sCSDH) with multiple membranes does not have a well-defined surgical approach. The neomembranes forming septations prevent evacuation of clots through burr holes, and the small remaining loculi with clots will enlarge overtime to cause recurrence. Methods: Patients with sCSDH were operated through a minicraniotomy (2.5 cm × 2.5 cm) using rigid endoscopes for visualization of the subdural space. Using endoscope, the entire subdural space can be visualized. The neomembranes are removed with standard neurosurgical microinstruments. The entire cavity is irrigated under vision to remove all clots and ensures hemostasis. Results: Eighty-three endoscope-assisted evacuations were done in 68 patients from January 2016 to April 2020. Fifty (73.5%) patients had unilateral and 18 (26.5%) had bilateral subdural. Only 1 patient (1.47%) had a clinically significant recollection of subdural bleeding 1 month after the procedure. Over a mean follow-up period of 25.3 months (range 1–53 months), rest of patients did not show any recollection. Conclusion: Endoscopic evacuation of sCSDH is a safe and effective method and can be used to improve clot evacuation, and remove neomembranes under direct vision to reduce the rates of recollection. This method also obviates the need for larger craniotomies to remove membranes.

Cerebral Aspergillosis after Burr-Hole Surgery for Chronic Subdural Hematoma: Case Report

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 332-335 ◽  
Author(s):  
Takato Morioka ◽  
Takatoshi Tashima ◽  
Shinji Nagata ◽  
Masashi Fukui ◽  
Kanehiro Hasuo
Keyword(s):  
Brain Tumor ◽  
Case Report ◽  
Frontal Lobe ◽  
Clinical Features ◽  
Subdural Hematoma ◽  
Clinical Course ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Neurosurgical Procedures ◽  
Subdural Space

Abstract We report a case of aspergillosis in the subdural space and frontal lobe in an 83-year-old man. The clinical course simulated that of a brain tumor. The source for the infection was considered to be the previous burr-hole surgery for chronic subdural hematoma, which was performed 2.5 years before the onset of symptoms. The patient was treated by removal of the abscess and granuloma. The clinical features and treatment of aspergillosis after neurosurgical procedures are discussed.

Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage

2000 ◽  
Vol 93 (5) ◽  
pp. 791-795 ◽  
Author(s):  
Hiroshi Nakaguchi ◽  
Takeo Tanishima ◽  
Norio Yoshimasu
Keyword(s):  
Recurrence Rate ◽  
Closed System ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Postoperative Recurrence ◽  
Ct Scans ◽  
Subdural Space ◽  
Content Type ◽  
Drainage Catheter ◽  
Fine Print

Object. This study was conducted to determine the best position for the subdural drainage catheter to achieve a low recurrence rate after burr-hole irrigation and closed-system drainage of chronic subdural hematoma (CSDH).Methods. The authors studied 63 patients with CSDH in whom the drainage catheter tip was randomly placed and precisely determined on postoperative computerized tomography (CT) scans and 104 patients with CSDH in whom CT scans were obtained 7 days postsurgery. The location of the subdural drainage catheter, the maximum postoperative width of the subdural space, and the percentage of the ipsilateral subdural space occupied by air postoperatively were determined and compared with the postoperative recurrence and reoperation rates.Patients with parietal or occipital drainage had a higher rate of CSDH recurrence and much more subdural air than those with frontal drainage. In addition, patients with residual subdural air demonstrated on CT scans obtained 7 days postsurgery also had a higher recurrence rate than those without subdural air collections. Furthermore, patients with a subdural space wider than 10 mm on CT scans obtained 7 days postsurgery had a higher recurrence rate than those with a space measuring 10 mm or less.Conclusions. The incidence of postoperative fluid reaccumulation seems to be reduced by placing the tip of the drainage catheter in the frontal convexity and by removing subdural air during or after surgery.

scholarly journals Xiaoyukang Jiaonang Promotes the Degradation of Hypoxia-Inducible Factor 1α and Antiangiogenesis and Anti-Inflammation in Chronic Subdural Hematoma Rat Model

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jialin Liu ◽  
Xiaoke Dong ◽  
Zhonghao Li ◽  
Gesheng Wang ◽  
Yujia Zhou ◽  
...  
Keyword(s):  
Rat Model ◽  
Subdural Hematoma ◽  
Sham Group ◽  
Hypoxia Inducible Factor ◽  
Chronic Subdural Hematoma ◽  
Physiological Saline ◽  
Iliac Vein ◽  
Medical Product ◽  
National Medical ◽  
Anti Inflammatory

Xiaoyukang Jiaonang (XYK) is a Chinese patent medicine approved by the National Medical Product Administration which is used to treat intracranial hematoma in China. In this study, we observed the molecular mechanism of XYK in hypoxia-inducible factor 1α (HIF-1α), inflammation and angiogenesis of chronic subdural hematoma (CSDH). The CSDH model was made by using internal iliac vein blood of Wister rats, and rats were divided into sham group, CSDH group and XYK group. The rats in the XYK group were gavaged with Xiaoyukang Jiaonang (185 mg/kg) for 7 days, and rats in the CSDH group and sham group were gavaged with the same amount of physiological saline for 7 days. In the CSHD rat model, active inflammation and angiogenesis were observed around the hematoma. XYK promoted the ubiquitination and degradation of HIF-1α, and reduced the concentration of VEGF and the ratio of angiopoietin-1/angiopoietin-2. XYK reduced proinflammatory cytokines and increased anti-inflammatory cytokine. In tissue section, XYK reduced the size of the hematoma and membrane, and reduced vWF positive cells in membrane. Furthermore, the endothelial progenitor cells in blood decreased as well. Overall, XYK shows anti-inflammatory and antiangiogenesis effects which may relate to the degradation of HIF-1α.

Role of local hyperfibrinolysis in the etiology of chronic subdural hematoma

1976 ◽  
Vol 45 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Haruhide Ito ◽  
Shinjiro Yamamoto ◽  
Toshio Komai ◽  
Hidetaka Mizukoshi
Keyword(s):  
Subdural Hematoma ◽  
Degradation Products ◽  
Chronic Subdural Hematoma ◽  
Subdural Space ◽  
Human Fibrinogen ◽  
Content Type ◽  
The Mean ◽  
Continuous Bleeding ◽  
Fine Print

✓ The authors describe studies performed on material aspirated from chronic subdural hematomas. Patients were given 51Cr-labeled red cells prior to aspiration, and it was possible to demonstrate that the mean daily hemorrhage into the hematoma space amounted to 10.2% of its volume. Immunoelectrophoresis of the aspirated hematoma fluid by monospecific anti-human fibrinogen revealed the presence of fibrin and fibrinogen degradation products that, measured by hemagglutination-inhibition immunoassay techniques, varied between 5.0 and 10,500 µg/ml with an average of 2604 µg/ml in 18 cases. The tissue activator was demonstrated by Todd's histological localization in the outer membrane of the chronic subdural hematoma in 11 cases, but not in the inner membrane. These results indicate that if a clot in the subdural space causes the formation of neomembrane, and excessive fibrinolysis occurs, the subdural clot would not only liquefy, but also enlarge by continuous hemorrhage from the neomembrane. Therefore, local hyperfibrinolysis and continuous bleeding are important in the etiology of the chronic subdural hematoma.

194 Endoscopic Assisted Evacuation of Chronic Subdural Hematoma A Paradigm Shift or a Waste of Time?

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 251-252 ◽  
Author(s):  
Netanel Benshalom ◽  
Sagi Harnof ◽  
Uzi Ben David
Keyword(s):  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Positive Impact ◽  
Chronic Subdural Hematoma ◽  
Subdural Space ◽  
Recurrence Rates ◽  
Early Recovery ◽  
Closed Drainage ◽  
Clinical And Radiological Outcome ◽  
Endoscope Guidance

Abstract INTRODUCTION Chronic subdural hematoma (CSDH) is a common neurosurgical condition encountered by neurologists and neurosurgeons. The incidence appears to be as high as 13.1 cases per 100,000 inhabitants and the peak incidence currently occurs in the eighth decade. The mainstay handling a symptomatic CSDH requires surgical evacuation, copious irrigation of blood clots with possible post operative temporary closed drainage. For decades Twist-drill craniostomy (TDC) and Burr-hole craniostomy played the main roles in the surgical approached with relatively high recurrence rates. It is emphasized that the highest risk for recurrence is seen with a mixed-density and layering type of hematoma on cranial CT and is probably due to the lack of adequate evacuation of the offending effusion due to limited exposure. METHODS We assigned 30 consentable adult patients undergoing surgery for presumed subacute/chronic SDH. Included are symptomatic patients with crescent-shaped hypo or isodense hematoma over the cerebral hemisphere, measuring minimal diameter of 10 mm regardless the extent of midline shift. Under general anesthesia traditional BHC approach was used, followed by introduction of 0° rigid endoscope. Using the endoscope guidance we performed thorough inspection of the subdural space, residual clots evacuation, internal membranes fenestration and occasional vessels coagulation. All patients underwent pre and post PT/OT evaluation. Clinical and Radiological follow-up was conducted immediate Post-op, 10 days and 3 months after the procedure. Standardized modified Rankin scale used to evaluate patients recovery. RESULTS >Our preliminary results show significantly better clinical and radiological outcome, early recovery and ambulation, fewer recurrence rate and less patients requiring post op drainage. Those findings upon validation can definitely change the traditional way we treat one of the most common neurosurgical conditions. CONCLUSION Its speculated that an endoscopically assisted CSDH procedures enables an improved extent of clot removal and release of loculated compartments. Logically, evacuating more of the hyper osmotic content in the subdural space should reduce membranous irritation with the consequent re-bleeding thus recurrence. Under vision control of bleeding source might have a positive impact on infection rate, recurrence rate and patient safety respectivey.

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