Journal of Korean Society of Geriatric Neurosurgery 2015;11(1):31-37.
Published online June 30, 2015.
The Correlation between Molecular Marker of the Traumatic Chronic Subdural Hematoma and the Intensity of Trauma in the Patients Aged over 65 Years
Kyungmin Lee , Ki-Su Park , Kyoung-Tae Kim , Seong Hyun Park , Jeong-Hyun Hwang , Sung Kyoo Hwang
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea
65세 이상 고령 환자에서 외상성 만성 경막하 혈종 내 분자 마커와 외상 강도 사이의 연관성
경북대학교 의과대학 신경외과학교실
The purpose of this study was to investigate whether the intensity of trauma influences the molecular markers of traumatic chronic subdural hematoma in elderly (CSDH).
Twenty one patients aged 65 and over, treated surgically for traumatic CSDH, were divided into high-impact and low-impact groups according to the intensity of trauma. They were respectively evaluated with respect to clinical and radiological findings at presentation, and the subdural concentrations of molecular markers such as interleukin-6 (IL-6), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), basic fibroblast growth factor, and beta-trace protein (βTP) [a highly specific protein in the cerebrospinal fluid (CSF)] related to the pathogenesis of CSDH. If βTP (subdural fluid/serum) >2, an admixture of CSF to the subdural fluid was indicated.
The βTP (subdural fluid/serum) was >2 in all patients with a traumatic CSDH. The mean concentration of subdural βTP in the high-impact group was higher than in the low-impact group (7.4mg/L versus 3.6mg/L), and the difference was statistically significant (p=0.001). In addition, mean concentrations of IL-6, IL-8 and VEGF were higher in the high-impact group, as compared to the low-impact group, though the differences did not reach statistical significance.
Trauma may be related to CSF leakage into the subdural space in CSDH, and the intensity of trauma may influence the amount of CSF leakage. Although there is no direct correlation between the amount of CSF leakage and other subdural molecules, the intensity of trauma may be associated with larger molecular concentrations of traumatic CSDH in elderly.
Key Words: TraumaㆍChronic subdural hematomaㆍBeta-trace proteinㆍCerebrospinal fluid

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