Pathophysiology of chronic subdural hematoma-new insights - PubMed
5 hours ago
- #neuroinflammation
- #angiogenesis
- #neurosurgery
- Chronic subdural hematoma (CSDH) involves persistent accumulation in the dural border cell layer, driven by a cycle of inflammation, angiogenesis, and impaired resolution.
- Injury leads to fibroproliferative membrane formation via collagen and TGF-β1/SMAD signaling, with fragile neovasculature from VEGF causing recurrent microhemorrhage and fibrinolysis.
- Chronic inflammation is sustained by macrophage polarization and cytokines, worsened by aging and hypoxia, while impaired tissue repair and lymphatic dysfunction prevent clearance.
- Pharmacological strategies targeting inflammation, angiogenesis, and matrix remodeling may complement surgical drainage or middle meningeal artery embolization.
- Translational research is needed for mechanism-driven, multimodal management as CSDH incidence rises.