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.

No abstract

To determine the possible role of matrix metallopeptidase (MMP)-8 and MMP-9 in the development of chronic subdural hematoma (CSDH), we investigated their expression in CSDH. In our previous study, we analyzed hematoma fluid and peripheral blood of 83 patients with CSDH, including 17 postoperative patients. Based on these results, we included 50 people in the normal group and analyzed 20 markers in the peripheral blood of each person. In order to identify representative markers, it was assessed by using overall differential gene expression. The concentration of MMP-8 was significantly higher in the normal group than that in the preoperative and postoperative groups. The concentration of MMP-9 was significantly lower in the normal group than in both preoperative and postoperative groups. Immunohistochemistry confirmed the expression of MMP-8 and MMP-9 in CSDH membranes. In conclusion, our results provide evidence of the expression of MMP-8 and MMP-9 in CSDH. In addition, the expression of MMP-8 and MMP-9 suggests angiogenesis in CSDH formation.

No abstract

Background Chronic subdural hematoma (CSDH) is a common neurological disorder in older patients, and immediate outcomes of surgery for CSDH are satisfactory. However, the evidence for subperiosteal drainage (SPD) versus subdural drainage (SDD) in CSDH remains controversial. In this study, we aimed to assess the latest evidence on the use of SPD versus SDD in patients with CSDH who underwent burr hole evacuation. Methods We performed a systematic literature search on the use of SPD compared with that of SDD in patients with CSDH in PubMed, Web of Science, Embase, and Cochrane online databases from inception until December 2021. The inclusion and exclusion criteria were defined for eligible studies. A fixed-effects model was used when homogeneity was observed. Results A total of 1013 participants from six studies were included. There were no significant differences in the recurrence rate (odds ratios [OR], 0.87; 95% confidence interval [CI], 0.61–1.26; I2 = 0%; P = 0.47) or the mortality rate (P = 0.89) between the SPD and SDD groups. Additionally, various characteristics, including the rate of subsequent seizures (P = 0.74), sex distribution (P = 0.37), and favorable clinical outcome rates (OR, 1.13; 95% CI, 0.74–1.72; I2 = 0%; P = 0.58), were also similar between the two groups. Moreover, there was no significant difference in the effects of antithrombotic agents between the two groups (P = 0.12). Conclusions There were no differences in recurrence rates, sex distribution, postoperative mortality, seizures, favorable outcomes (modified Rankin scale score: 0–3), or effects of antithrombotic agents between the SPD and SDD groups. These findings suggest that both SPD and SDD are equally effective in treating patients with CSDH.