Vascular endothelial growth-permeability factor in granulation tissue of chronic subdural haematomas.

BACKGROUND

Vascular Endothelial Growth/Permeability Factor (VEG/PF) has been correlated with angiogenesis and vascular leakage in diverse pathological conditions of the brain. On the other hand, neoformation of capillaries and vascular hyperpermeability have been related to progressive enlargement of chronic subdural haematomas (CSDH). The purpose of the present study is to verify the presence of VEG/PF in tissue of CSDH, with the hypothesis that neovascularization and vascular hyperpermeabitity in CSDH can be related to the presence of this cytokine.

METHODS

Immunohistochemical studies and Reverse Transcription Polymerase Chain Reaction (RT-PCR) analysis were performed in the neomembranes of 12 CSDH to verify presence of VEG/PF in this tissue.

FINDINGS

Strong expression of VEG/PF was immunohistochemically disclosed in neomembranes of CSDH, as well as in inflammatory cells currently infiltrating this tissue. Furthermore, RT-PCR studies showed the presence of VEG/PF in all the studied samples.

INTERPRETATION

These findings suggest a role for inflammatory cells, currently present in the granulation tissue of CSDH, in the release of VEG/PF and in the enlargement of these lesions, stating the possibility of a new therapeutic approach to CSDH, based on blocking the physiological effects of VEG/PF.