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Iran J Neurosurg 2025, 11 - Continuous Publishing: 0-0 |
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Adhikesavan S, Krishnaswamy V, Swamiyappan S S, Visvesvaran V, Kannan B. Radiological and Biochemical Characteristics of Chronic Subdural Hematoma. Iran J Neurosurg 2025; 11 : 17
URL: http://irjns.org/article-1-455-en.html
URL: http://irjns.org/article-1-455-en.html
Sangeetha Adhikesavan1 
, Visvanathan Krishnaswamy1 
, Sai Sriram Swamiyappan *2 , Vivek Visvesvaran1 , Balasubramanian Kannan1
, Visvanathan Krishnaswamy1 , Sai Sriram Swamiyappan *2 , Vivek Visvesvaran1 , Balasubramanian Kannan1
1- Sri Ramachandra Medical College and Research Institute, Chennai, India.
2- Sri Ramachandra Medical College and Research Institute, Chennai, India. ,saisriramswamiyappan@gmail.com
2- Sri Ramachandra Medical College and Research Institute, Chennai, India. ,
Abstract: (15 Views)
Background and Aim: Chronic subdural hematomas (CSDH) are a common neurosurgical issue characterized by the accumulation of blood between the brain and its outermost protective membrane. The pathogenesis of CSDH involves a cycle of recurrent hemorrhage, fibrinolysis, inflammation, and angiogenesis. D-dimer, a marker of fibrinolysis, has been investigated in CSDH. This study explores the correlation between D-dimer levels, computed tomography (CT) findings, and recurrence of CSDH.
Methods and Materials/Patients: This prospective study included 80 patients with CSDH who underwent surgical evacuation between 2018 and 2020. The CSDHs were classified based on CT scan appearance, and D-dimer levels were measured in the hematoma fluid and peripheral blood samples. The statistical analysis was performed to identify correlations between D-dimer levels, CT subtypes, and recurrence rates.
Results: The mean D-dimer value in the Hypodense group was 454.2 mg/L while the value in the isodense group was 777.74 mg/L. The highest mean value was observed in the mixed subgroup, at 2370 mg/L. The layered group had a mean value of 1146.85 mg/L. The mean D-dimer value in the homogenous group was 622.48 mg/L while the mean in the heterogenous group was 2014.57 mg/L. There was a statistically significant correlation between the imaging subtypes and the D-dimer values (P=0.01).
Conclusion: The mean D-dimer values were highest in the mixed subtype of CSDH, followed by the layered subtype, while the hypo- and isodense subtypes had lower D-dimer levels. There was a significant correlation between the imaging subtypes and D-dimer values. Additionally, a higher rate of recurrence was observed in the mixed subtype group, which also had higher D-dimer values. Steroid administration after surgery showed a statistically significant negative correlation with recurrence rates.
Methods and Materials/Patients: This prospective study included 80 patients with CSDH who underwent surgical evacuation between 2018 and 2020. The CSDHs were classified based on CT scan appearance, and D-dimer levels were measured in the hematoma fluid and peripheral blood samples. The statistical analysis was performed to identify correlations between D-dimer levels, CT subtypes, and recurrence rates.
Results: The mean D-dimer value in the Hypodense group was 454.2 mg/L while the value in the isodense group was 777.74 mg/L. The highest mean value was observed in the mixed subgroup, at 2370 mg/L. The layered group had a mean value of 1146.85 mg/L. The mean D-dimer value in the homogenous group was 622.48 mg/L while the mean in the heterogenous group was 2014.57 mg/L. There was a statistically significant correlation between the imaging subtypes and the D-dimer values (P=0.01).
Conclusion: The mean D-dimer values were highest in the mixed subtype of CSDH, followed by the layered subtype, while the hypo- and isodense subtypes had lower D-dimer levels. There was a significant correlation between the imaging subtypes and D-dimer values. Additionally, a higher rate of recurrence was observed in the mixed subtype group, which also had higher D-dimer values. Steroid administration after surgery showed a statistically significant negative correlation with recurrence rates.
Article number: 17
Type of Study: Research |
Subject:
Basic Neurosurgery
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This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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