Mechanism of subdural effusion evolves into chronic subdural hematoma: IL-8 inducing neutrophil oxidative burst

Tao, Zhiqiang; Lin, Yingying; Hu, Maotong; Ding, Shenghong; Li, Jianwei; Qiu, Yongming

doi:10.1016/j.mehy.2015.11.027

Cited by 21 publications

(6 citation statements)

References 20 publications

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“…Trauma is the main cause of CSDH, leading to the rupture of the bridging vein or cerebral cortex blood vessel, followed by accumulation of blood in the subdural space (6). Inflammatory response, angiogenesis, subdural effusion evolution and local coagulation disorders contribute to CSDH as well (15,16). Among many factors associated with the recurrence of CSDH, MDH is an independent risk factor for the recurrence and reoperation of CSDH (12).…”

Section: Discussionmentioning

confidence: 99%

Rigid Neuroendoscopy Assisted Hematoma Resection Reduces the Recurrence Rate of Chronic Subdural Hematoma With Mixed Density: A Retrospective Analytic Cohort Study

et al. 2022

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BackgroundThe mixed density hematoma (MDH) has a high recurrence rate in chronic subdural hematoma (CSDH). This study adopted rigid neuroendoscopy assisted hematoma resection to evacuate CSDH and investigated its efficacy as compared with the traditional burr-hole craniostomy (BHC) in CSDH with mixed density.MethodsA retrospective cohort study was conducted at two centers between January 2015 and December 2020. The data of 124 patients who underwent BHC for CSDH with mixed density were collected and analyzed. A total of 41 patients underwent rigid neuroendoscopy assisted hematoma resection (neuroendoscopy group) and 83 patients were treated by the traditional BHC (control group). Follow-ups were conducted 6 months after the surgery.ResultsThere was no significant difference in the baseline characteristics and preoperative CT features between the two groups (p > 0.05). The neuroendoscopy group had a lower recurrence rate than the control group (p = 0.043). Besides the neuroendoscopy group had a higher rate of hematoma evacuation (p < 0.001), less pneumocephalus volume (p < 0.001), shorter hospital stay (p < 0.001) and better Markwalder score (p < 0.001) than the control group within 24–48 h after operation. However, there was no significant difference between the two groups in the incidence of pneumocephalus, Markwalder score (at discharge and 6 months after surgery) and mortality. Moreover, the operation time was longer in the neuroendoscopy group (p < 0.001).ConclusionsWhen compared with the traditional BHC, rigid neuroendoscopy assisted hematoma resection can better reduce the recurrence rate of CSDH with mixed density. Also, it surpassed the results obtained from BHC in reducing the volume of pneumocephalus, improving hematoma evacuation rate, promoting short-term neurological recovery, and shortening hospital stays.

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Section: Discussionmentioning

confidence: 99%

Rigid Neuroendoscopy Assisted Hematoma Resection Reduces the Recurrence Rate of Chronic Subdural Hematoma With Mixed Density: A Retrospective Analytic Cohort Study

et al. 2022

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“…In the process of hematoma formation, the blood protein components in the hematoma degrade to form small molecular inflammatory mediators that could induce the proliferation of the border cells of the dura mater and arachnoid to form envelopes and secrete IL-6, IL-8, and other cytokines (Hong et al 2009). IL-8 also induces inflammatory cell infiltration, chemotaxis, and vascular proliferation, intact capillary intima, inflammatory cell infiltration, and continuous microbleeding, which gradually leads to changes in the composition of fluids and affects the absorption of exudates (Tao et al 2016). In addition, the inflammatory mediators released by some inflammatory cells lead to a series of pathological processes, such as the coagulation mechanism disorder in the hematoma cavity and the hyperplasia of the fibrinolytic system, causing the hematoma to expand continuously and produce clinical symptoms (Zhang et al 2019).…”

Section: Discussionmentioning

confidence: 99%

Atorvastatin-Induced Absorption of Chronic Subdural Hematoma Is Partially Attributed to the Polarization of Macrophages

Yang

et al. 2021

J Mol Neurosci

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As one of the main types of secondary craniocerebral injury, the onset, progression, and prognosis of chronic subdural hematoma (CSDH) are closely related to the local inflammation of intracranial hematoma. Atorvastatin is reported to be effective in the conservative treatment of CSDH. This study aimed to clarify whether atorvastatin regulated the inflammatory responses in CSDH by interfering with the function of macrophages. The rat CSDH model was prepared by repeated intracranial blood injection with velocity gradient, and MRI was applied to calculate the intracranial hematoma volume. Changes in rat nerve functions were evaluated by foot-fault and Morris water maze tests. Flow cytometry was applied to detect the number of total macrophages and the percentage of M1 or M2 macrophages. The expression of inflammatory factors was examined by ELISA and western blot. Western bolt was applied to detect the expression of proteins involved in the colony-stimulating factor 1 receptor (CSF-1R) signaling pathway. Our results showed that atorvastatin significantly accelerated the absorption of hematoma and improved the nerve functions of CSDH rats. In addition, atorvastatin treatment effectively suppressed the expression of TNF-α, IL-6, and IL-8 and promoted the expression of IL-10. The total number of macrophages was decreased, and the percentage of M2 macrophages was increased in the intracranial hematoma following atorvastatin treatment. Furthermore, atorvastatin increased the levels of M2-related genes and surface markers in BMDMs stimulated by lipopolysaccharides and IFNγ, and activated the CSF-1R signaling pathway. In conclusion, our study shows that atorvastatin could alleviate the symptoms of CSDH and promote hematoma ablation by polarizing macrophages to M2 type and regulating the inflammatory responses. KeywordsChronic subdural hematoma (CSDH) • Rat model • Atorvastatin • Inflammatory responses • Macrophages • Colony-stimulating factor 1 receptor (CSF-1R) * Zongmao Zhao

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“…Another study has found that patients with high concentrations of anti-inflammatory cytokine IL-10 also had high values for IL-6 and CXCL8, in addition to a tendency to be associated with a separated or layer type of hematoma [ 28 ]. It has been proposed that CXCL8 inducing a neutrophil respiratory burst is the crucial impact when subdural effusion develops into CSDH, and that an increased concentration of CXCL8 may increase the risk of RrR [ 29 ]. We found though that the concentration of CXCL8 was high compared to the other assessed biomarkers ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Association between biomarkers and clinical characteristics in chronic subdural hematoma patients assessed with lasso regression

Pripp

Stanišić

2017

PLoS ONE

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Chronic subdural hematoma (CSDH) is characterized by an “old” encapsulated collection of blood and blood breakdown products between the brain and its outermost covering (the dura). Recognized risk factors for development of CSDH are head injury, old age and using anticoagulation medication, but its underlying pathophysiological processes are still unclear. It is assumed that a complex local process of interrelated mechanisms including inflammation, neomembrane formation, angiogenesis and fibrinolysis could be related to its development and propagation. However, the association between the biomarkers of inflammation and angiogenesis, and the clinical and radiological characteristics of CSDH patients, need further investigation. The high number of biomarkers compared to the number of observations, the correlation between biomarkers, missing data and skewed distributions may limit the usefulness of classical statistical methods. We therefore explored lasso regression to assess the association between 30 biomarkers of inflammation and angiogenesis at the site of lesions, and selected clinical and radiological characteristics in a cohort of 93 patients. Lasso regression performs both variable selection and regularization to improve the predictive accuracy and interpretability of the statistical model. The results from the lasso regression showed analysis exhibited lack of robust statistical association between the biomarkers in hematoma fluid with age, gender, brain infarct, neurological deficiencies and volume of hematoma. However, there were associations between several of the biomarkers with postoperative recurrence requiring reoperation. The statistical analysis with lasso regression supported previous findings that the immunological characteristics of CSDH are local. The relationship between biomarkers, the radiological appearance of lesions and recurrence requiring reoperation have been inclusive using classical statistical methods on these data, but lasso regression revealed an association with inflammatory and angiogenic biomarkers in hematoma fluid. We thus suggest that lasso regression should be a recommended statistical method in research on biological processes in CSDH patients.

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Mechanism of subdural effusion evolves into chronic subdural hematoma: IL-8 inducing neutrophil oxidative burst

Cited by 21 publications

References 20 publications

Rigid Neuroendoscopy Assisted Hematoma Resection Reduces the Recurrence Rate of Chronic Subdural Hematoma With Mixed Density: A Retrospective Analytic Cohort Study

Rigid Neuroendoscopy Assisted Hematoma Resection Reduces the Recurrence Rate of Chronic Subdural Hematoma With Mixed Density: A Retrospective Analytic Cohort Study

Atorvastatin-Induced Absorption of Chronic Subdural Hematoma Is Partially Attributed to the Polarization of Macrophages

Association between biomarkers and clinical characteristics in chronic subdural hematoma patients assessed with lasso regression

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