Tang Jingyang, Ai Jinglu, Macdonald R Loch
Division of Neurosurgery, Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Department of Surgery, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Acta Neurochir Suppl. 2011;111:25-9. doi: 10.1007/978-3-7091-0693-8_5.
Chronic subdural hematoma (CSDH) is a common neurosurgical condition that has a high incidence in the increasing elderly population of many countries. Pathologically, it is defined as a persistent liquefied hematoma in the subdural space more than 3 weeks old that is generally encased by a membraneous capsule. CSDHs likely originate after minor head trauma, with a key factor in its development being the potential for a subdural cavity to permit its expansion within, which is usually due to craniocerebral disproportion. The pathogenesis of CSDH has been attributed to osmotic or oncotic pressure differences, although measurements of these factors in the CSDH fluid do not support this theory. Current belief is that CSDH arises from recurrent bleeding in the subdural space, caused by a cycle of local angiogenesis, inflammation, coagulation and ongoing fibrinolysis. However, because of a lack of detailed knowledge about the precise mechanisms, treatment is often limited to surgical interventions that are invasive and often prone to recurrence. Thus, it is possible that an easily reproducible and representative animal model of CSDH would facilitate research in the pathogenesis of CSDH and aid with development of treatment options.
慢性硬膜下血肿（CSDH）是一种常见的神经外科疾病，在许多国家老年人口不断增加的情况下发病率较高。从病理学角度来看，它被定义为硬膜下间隙中持续存在的液化血肿，病程超过3周，通常被一层膜性包膜包裹。CSDH可能起源于轻微头部外伤后，其发展的一个关键因素是硬膜下腔允许其在内部扩张的可能性，这通常是由于颅脑比例失调所致。CSDH的发病机制归因于渗透压或胶体渗透压的差异，尽管对CSDH液中这些因素的测量并不支持这一理论。目前的观点认为，CSDH源于硬膜下间隙的反复出血，这是由局部血管生成、炎症、凝血和持续纤维蛋白溶解的循环引起的。然而，由于对确切机制缺乏详细了解，治疗往往局限于侵入性且易复发的手术干预。因此，一个易于复制且具有代表性的CSDH动物模型可能会促进CSDH发病机制的研究，并有助于开发治疗方案。
