[Growing factors of chronic subdural hematoma--significance of CK activity in hematoma contents and neomembrane].

The growing mechanism of the chronic subdural hematoma has not fully understood yet, in spite of numerous studies about hematoma neomembranes. However, it is well known that the majority of the chronic subdural hematomas are well healed by a simple irrigation of hematoma. These facts suggested that the hematoma contents could have important growing factors of the chronic subdural hematoma. Thus, LDH and CK activities were estimated in 52 cases of hematoma contents and 15 cases of hematoma neomembranes in order to search growing factors, biochemically. Hematocrit and hemoglobin values in hematoma contents were also examined simultaneously. As a result, hematocrit and hemoglobin values in hematoma contents were gradually increased, these facts might be due to the concentration of hematoma contents. LDH and CK activities in hematoma contents were high around 60 days after the hematoma inducing head trauma, and these enzyme activities were not correlated with hematocrit value. In isozyme analysis of LDH and CK activities, LDH-1,2 and CK-MM showed high values but CK-BB, MB could not be recognized. These findings suggested that LDH activity in the hematoma contents were caused by hemolysis which had been reported to be a main cause, and CK activity might originate from muscular tissues. Therefore, author hypothesized that the CK activity in hematoma contents had originated from the neomembrane, since there was a good correlation between the mature stage of neomembrane and the high level of CK-MM, and the myofibroblast was found in neomembrane recently. CK-MM could be released from the myofibroblast in neomembrane. However, CK activity in hematoma neomembrane could not be recognized, biochemically nor immunohistochemically.(ABSTRACT TRUNCATED AT 250 WORDS)