The underlying mechanism of chronic subdural hematoma (CSDH) after minor head injury is complex, probably due to mechanical injury of the arachnoid membrane, hematological coagulopathy, and pathological angiogenesis in the dura caused by inflammatory cytokines including vascular endothelial growth factor (VEGF).

To confirm whether VEGF might be a reliable predictive biomarker for the natural history of CSDH, including progression and recurrence, we analyzed the correlation of VEGF concentration in the subdural fluid with CT findings and clinical features, including interval from minor head injury. Based on CT classification by hematoma density, the mean concentration of VEGF in hematoma fluid was found to be highest in the trabecular group, whereas the recurrence of CSDH was most frequent in the separated group in which VEGF concentration was low. There was a significant correlation between VEGF concentration and the CT classification. Furthermore, only in the trabecular group, a significant negative correlation between the VEGF concentration and interval from minor head injury to surgery was observed. These results suggest that VEGF concentration in the hematoma alone could not be a reliable predictive biomarker for the natural history of CSDH including its recurrence. Amongst the classified groups of CSDH, the trabecular group is likely to follow a different time course of VEGF concentration in the hematoma fluid compared to the other three groups.

轻度颅脑损伤后慢性硬膜下血肿 (CSDH) 的潜在机制很复杂，可能是由于蛛网膜的机械损伤、血液凝固病和由血管内皮生长因子 (VEGF) 等炎性细胞因子引起的硬脑膜病理性血管生成。

为了确认 VEGF 是否可能是 CSDH 自然病程（包括进展和复发）的可靠预测生物标志物，我们分析了硬膜下液中 VEGF 浓度与 CT 发现和临床特征（包括轻微头部损伤的间隔）的相关性。根据血肿密度的 CT 分类，发现血肿液中 VEGF 的平均浓度在小梁组中最高，而 CSDH 的复发在 VEGF 浓度较低的分离组中最常见。VEGF浓度与CT分类之间存在显着相关性。此外，仅在小梁组中，观察到 VEGF 浓度与从轻微头部损伤到手术的间隔之间存在显着的负相关。这些结果表明，仅血肿中的 VEGF 浓度不能成为 CSDH 自然病程（包括其复发）的可靠预测生物标志物。在分类的 CSDH 组中，与其他三组相比，小梁组可能遵循不同的血肿液中 VEGF 浓度的时间过程。