Elsevier

Surgical Neurology

Volume 30, Issue 3, September 1988, Pages 175-179
Surgical Neurology

Tissue-type plasminogen activator in the chronic subdural hematoma

https://doi.org/10.1016/0090-3019(88)90269-8Get rights and content

Abstract

We measured the concentrations of tissue-type plasminogen activator (t-PA) in 92 patients with chronic subdural hematoma involving 102 sites. The t-PA level in the normal plasma was 4.0 ± 1.8 ng/mL (mean ± SD), while that in the hematoma content of these patients was 11.2 ± 6.2 ng/mL. Patients showing stupor (grade 3) and coma (grade 4) had higher t-PA levels than those showing headache (grade 1) and somnolence (grade 2) or psychiatric disorder (grade 5). Also, those with the layer-type hematoma on computed tomographic images had higher t-PA levels than those with any other types. The t-PA level in the draining fluid decreased after surgery. In three patients showing a gradual increase of t-PA, subdural fluid reaccumulated and the general condition remained unchanged after surgery. Overproduction of t-PA is considered to initiate intermittent hemorrhage by conversion of plasminogen to plasmin and results in persistence or enlargement of chronic subdural hematoma.

References (12)

  • T Astrup et al.

    Estimation of the plasminogen activator and human tissue trypsin inhibitor in animal and human tissues

    Scand J Clin Lab Invest

    (1957)
  • N Bergsdorf et al.

    An enzyme linked immuno-sorbent assay for determination of tissue plasminogen activator applied to patients with thromboembolic disease

    Thromb Haemostasis

    (1983)
  • D Collen

    On the regulation and control of fibrinolysis

    Thromb Haemostasis

    (1980)
  • AP Fletcher et al.

    Abnormal plasminogen plasmin system activity (fibrinolysis) in patients with hepatic cirrhosis: its cause and consequences

    J Clin Invest

    (1964)
  • WJ Gardner

    Traumatic subdural hematoma with particular references to the latent interval

    Arch Neurol Psychiatry

    (1932)
  • H Ito et al.

    Fibrin and fibrinogen degradation products in chronic subdural hematoma

    Neurol Med Chir (Tokyo)

    (1975)
There are more references available in the full text version of this article.

Cited by (55)

  • Statins versus Nonstatin Use in Patients with Chronic Subdural Hematomas Treated with Middle Meningeal Artery Embolization Alone – A Single-Center Experience

    2022, World Neurosurgery
    Citation Excerpt :

    Vascular endothelial growth factor is also present in high levels causing a dysregulated neoangiogenic process and forming immature capillaries that can be easily disrupted or leak.4,5 Furthermore, it is also thought that increased levels of tissue plasminogen activator can be responsible for continuous fibrinolysis, precluding resolution of blood collection.10,14 The primary therapeutic mechanism of statins consists of inhibition of β-hydroxy β-methylglutaryl coenzyme A reductase leading to a lipid-lowering effect.11,15

  • History and current progress of chronic subdural hematoma

    2021, Journal of the Neurological Sciences
  • Predictive (subtle or overlooked) initial head CT findings in patients who develop delayed chronic subdural hematoma

    2017, Journal of Clinical Neuroscience
    Citation Excerpt :

    The etiology of chronic subdural hematoma (CSDH) remains uncertain [1–6].

View all citing articles on Scopus
View full text