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[Relationship between classification of CSDH according to the Internal architecture and hematoma contents]
Hiroshi Nakaguchi1, Akira Teraoka, Yasutaka Suzuki
1Department of Neurosurgery, Teraoka Memorial Hospital, 37 Ooaza Shinichi, Shinichi Town, Ashina Gun, Hiroshima Prefecture, 729-3103, Japan.
Insights
This study classified chronic subdural hematoma (CSDH) into four types based on CT scans. Findings reveal distinct relationships between CSDH types and specific hematoma content values, including red blood cells and hemoglobin.
Area of Science:
- Neurosurgery
- Radiology
- Hematology
Background:
- Chronic subdural hematoma (CSDH) classification based on CT-identified internal architecture.
- Four CSDH types identified: homogeneous, laminar, separated, and trabecular.
- Understanding CSDH heterogeneity is crucial for diagnosis and treatment.
Purpose of the Study:
- To statistically analyze the relationship between CSDH types and hematoma contents.
- To correlate imaging characteristics with biochemical markers in CSDH.
- To investigate potential differences in blood cell counts and protein levels among CSDH subtypes.
Main Methods:
- Assessment of 45 consecutive CSDH patients.
- Classification of CSDH into four CT-defined types.
- Analysis of blood cell counts (WBC, RBC, Hb, Ht, platelets), FDP, and fibrinogen in hematoma and peripheral blood.
Main Results:
- Significant variations in red blood cell (RBC) and hemoglobin (Hb) concentrations were observed across CSDH types.
- Trabecular (Tr) type showed the lowest mean RBC and Hb levels.
- Elevated eosinophil, lymphocyte, and FDP levels were noted across all CSDH types, while fibrinogen was consistently low.
Conclusions:
- Established relationships between CSDH types (homogeneous, laminar, separated, trabecular) and RBC, Hb, Ht, and CRP values.
- CT-based classification aids in understanding hematoma composition.
- Further research may elucidate the clinical implications of these subtype-specific hematological differences.
Background:
Based on the finding of temporal changes in the internal architecture on CT scans, we classified CSDH into 4 types: the homogeneous type, the laminar type, the separated type, and the trabecular type. The purpose of this study was to statistically analyze the relationship between the type of CSDH and the hematoma contents.
Methods:
This study assessed 45 consecutive CSDH patients. All of them were assigned to our 4 types of CT classification of CSDH, and the counts of blood cells including WBC, RBC, Hb, Ht, and platelets, as well as FDP and fibrinogen levels in the hematoma and peripheral venous blood were examined.
Results:
The mean RBC count was 345.3 (SD = 177.9) in all the subjects versus 426.4 (SD = 165.6) in Hm, 408.3 (SD = 79.2) in Lm, 357.2 (SD = 298.7) in Sp, and 200.0 (SD = 129.2) in Tr. The mean Hb concentration was 10.2 (SD = 5.2) in all the subjects versus 12.9 (SD = 5.3) in Hm, 12.3 (SD = 2.7) in Lm, 9.2 (SD = 6.5) in Sp, and 5.9 (SD = 4.2) in Tr. The eosinophil and lymphocyte counts were high in all the types (15.0% and 48.4% on average). The FDP concentration was high in all patients (500-5,000). Fibrinogen levels were less than 10 in all hematoma types. CRP was an average of 3.1 (SD = 4.9) in all the subjects versus 7.5 (SD = 9.8) in Hm, 2.5 (SD = 1.6) in Lm, 3.0 (SD = 2.9) in Sp, and 1.1 (SD = 1.6) in Tb.
Conclusion:
There were relationships between the type of CSDH and the RBC, Hb, Ht, and CRP values.
