Open Access

REVIEW

The pathogenesis of chronic subdural hematoma in the perspective of neomembrane formation and related mechanisms

by MINGYUE HUANG^1,#, JUNFEI DAI^1,#, XIANLIANG ZHONG², JIN WANG², JIANZHONG XU², BO DU^2,*

1 School of Medicine, Southern University of Science and Technology, Shenzhen, 518055, China
2 Department of Emergency, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, 518055, China

* Corresponding Author: BO DU. Email:

BIOCELL 2024, 48(6), 889-896. https://doi.org/10.32604/biocell.2024.050097

Received 27 January 2024; Accepted 11 April 2024; Issue published 10 June 2024

Abstract

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.

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Keywords

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