Table 1 Key mediators in CSDH pathophysiology
Mediator | Finding in CSDH |
|---|---|
Type 1 and type 3 procollagen | High levels in CSDH fluid signify fibro-proliferation occurring in CSDH which may relate to neomembrane formation [16, 33]. |
Thrombomodulin, TPA, fibrin and FDPs | Raised in CSDH fluid and signify hyperfibrinolytic activity occurring [28, 39,40,41, 74]. |
Angiopoietin-2 | Pro-angiogenic factor, mRNA in high levels in outer membrane of CSDH [29]. |
VEGF | Pro-angiogenic factor. Very high levels in CSDH fluid and mRNA in membranes and neutrophils [21,22,23, 29, 46,47,48,49, 53]. |
PGE2 | Regulates VEGF. High levels in CSDH fluid correlate with time from trauma [21]. |
HIF-1α | Regulates VEGF. High staining in outer membrane of CSDH [23]. |
MMP-1, -2 and -9 | Present in outer membrane and CSDH fluid. Contributes to poor capillary integrity [30, 48, 57]. |
Cytokines and chemokines | High levels of IL-6, IL-8, IL-10, TNF-α, MCP-1, eotaxin-3, CXCL9 and CXCL10 in CSDH fluid compared with serum [18, 21, 53, 61, 62, 73, 74, 80, 83]. |