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A novel paradigm for chronic subdural hematoma: regenerative medicine strategies targeting the pathological
Zhijian Xu1, Song Yang2, Guifang Zheng1
1Department of Neurosurgery, Jinhua Municipal Central Hospital, Jinhua, China.
Insights
Chronic subdural hematoma (CSH) involves complex microenvironment changes, including inflammation and abnormal angiogenesis. Regenerative medicine strategies like stem cell therapy offer new ways to treat CSH by remodeling the pathological environment.
Area of Science:
- Neuroscience
- Regenerative Medicine
- Pathology
Background:
- Chronic subdural hematoma (CSH) is a complex pathological process, not merely a mechanical collection of blood.
- CSH involves chronic inflammation, aberrant angiogenesis, extracellular matrix (ECM) imbalance, and immune cell interactions within its microenvironment.
Purpose of the Study:
- To systematically review the pathological microenvironment characteristics of CSH.
- To explore regenerative medicine strategies for CSH intervention by targeting its microenvironment.
Main Methods:
- Literature review focusing on cellular and molecular mechanisms in the CSH microenvironment.
- Analysis of regulatory strategies including immunomodulation, stem cell therapy, and exosome/nanomaterial delivery systems.
Main Results:
- CSH microenvironment is characterized by chronic inflammation, abnormal angiogenesis, and ECM imbalance.
- Regenerative approaches target inflammation, vascular leakage, and matrix remodeling to restore homeostasis.
Conclusions:
- Innovative strategies like stem cell therapy and nanomaterial delivery offer promising avenues for CSH treatment.
- These approaches advance CSH therapy from surgical drainage to microenvironment remodeling and functional reconstruction, providing a basis for precise regenerative clinical therapies.
Abstract:
This review systematically summarizes the pathological microenvironment characteristics of chronic subdural hematoma (CSDH) and the regenerative medicine strategies for its intervention. CSDH is no longer regarded as a simple mechanical hematoma but is recognized as a dynamic pathological process driven by chronic inflammation, abnormal angiogenesis, extracellular matrix (ECM) imbalance, and interactions among immune cells. The article focuses on key cellular and molecular mechanisms within the microenvironment and highlights regulatory strategies targeting inflammation, vascular leakage, and matrix remodeling. These strategies include immunomodulation, stem cell therapy, exosome- and nanomaterial-based delivery systems. Such innovative approaches aim to restore tissue homeostasis at the biological level, advancing CSDH treatment from traditional surgical drainage toward microenvironment remodeling and functional reconstruction. They provide a theoretical basis for achieving precise and regenerative clinical therapies.
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