TY  - EJOU
AU  - HUANG, MINGYUE 
AU  - DAI, JUNFEI 
AU  - ZHONG, XIANLIANG 
AU  - WANG, JIN 
AU  - XU, JIANZHONG 
AU  - DU, BO 

TI  - The pathogenesis of chronic subdural hematoma in the perspective of neomembrane formation and related mechanisms
T2  - BIOCELL

PY  - 2024
VL  - 48
IS  - 6
SN  - 1667-5746

AB  - Chronic subdural hematoma (CSDH) is a disease characterized by capsuled blood products that progressively occupy the intracranial space, causing intracranial hypertension and compression in the brain. CSDH frequently occurs in all demographics, especially in the elderly, but the pathogenesis of CSDH remains unclear. In this review, we discuss the origin, development, and current treatment strategies of CSDH. For the first time, we analyzed the cellular and molecular compositions of hematoma membranes with a focus on neomembrane formation, a complex early-stage interactive event in hematoma pathogenesis. We hypothesize that in patients with CSDH, dural border cells (DBCs) might be induced to synthesize collagen or serum proteins might accumulate at the dura and arachnoid layers at the site of injury, thereby encapsulating the hemorrhage. Membrane formation may trigger inflammatory responses after subdural hemorrhage, promoting fibroblast-involved extracellular matrix (ECM) deposition and aberrant angiogenesis within the outer membrane. Consequently, ECM deposition and angiogenesis mutually influence each other and are modulated by inflammatory processes. By illustrating the complex and interactive mechanism of neomembrane formation, we aim to provide a novel insight into CSDH pathogenesis and propose directions for future research as well as advancements in treatment strategies for this disease.
KW  - Chronic subdural hematoma; Inflammation; Angiogenesis; Extracellular matrix; Hyperfibrinolysis

DO  - 10.32604/biocell.2024.050097