Detection Of IL-6/VEGF And The Effect On Development In CSDH

Objective: The pathophysiology of Chronic subdural hematoma（CSDH） isrelevant to inflammation of the capsule membrane and neovascular ization, but itsunderlying mechanisms remain to be fully elucidated. In order to explore the role oflocal inflammation in hematoma, capsule and neovascularization in the generationand development mechanism of CSDH and investigate the pathogenesis of CSD H,and provide possible theoretical basis for the diagnosis and treatment of CSDH, wedetect the levels of IL-6, an important inflammation marker and vascular endothelialgrowth factor (VEGF) in serum/plasma and in the hematoma and observe thestructure of outer layer membrane of lesion in CSDHs.Method:20patients with CSDHs who were hospitalized and operated in theneurosurgery department of Shanghai Sixth People’s Hospital from September of2013to February of2014were selected. Among them,18males a nd2females, theaverage age of them was70±10.55,17patients had traumatic brain injury history. Thevolunteer,10healthy persons were studied as control group. Among them,9malesand1female, the average age of them was63±10.84. Samples of peripheral venousblood and of hematoma fluid (obtained during surgery) were collected and analyzed.Results:(1)There were disperate fibrocyte and small amounts capillary in the duralmater. Eosinophile granulocytes were widely spread and fibroblast and inflammatorycells were more or less in outer membrane of hematoma. At the same time, there werebig capillary and a number of red cells. Concentrations of VEGF were very high inthe lesion.(2) Concentration of VEGF in the hematoma fluid was significantlyincreased (P＜0.01) in comparison with that in the serum, while concentration of VEGF in the serum had no difference (P＞0.05) between patients with CSDHs andvolunteers.(3) Concentration of IL-6in the hematoma fluid was significantlyincreased (P＜0.01) in comparison with that in the serum, while concentration of IL-6in the serum had no difference (P＞0.05) between patients with CSDHs and healthvolunteers.Conclusion:1)The concentration of IL-6in the haematoma of CSDH is very high.Probably, IL-6participate in the local active inflammatory action as an importantinflammatory factor.2) The concentration of VEGF is moderate high in thehaematoma,but is markedly high in outer membrane of hematoma.So,VEGF may bean important factor in the formation of new vessels.3)IL-6and VEGF may play animportant role synergistically in the development of CSDH and induce thehaematoma to enlarge ultimately.