Fibrinogen and D-dimer analysis of chronic subdural hematomas and computed tomography findings: a prospective study

Clin Neurol Neurosurg. 2011 May;113(4):272-6. doi: 10.1016/j.clineuro.2010.11.014. Epub 2010 Dec 14.

Abstract

Objective: We investigated the relationship between fibrinolytic factors and computed tomography (CT) findings in patients with chronic subdural hematomas (CSDHs).

Methods: Thirty-one patients with CSDHs were divided on the basis of CT findings into heterogeneous and homogeneous groups. A sample from the subdural hematoma was obtained at surgery to measure the concentrations of fibrinogen and D-dimer.

Results: The mean level of fibrinogen in the heterogeneous group, including the layering (n=4) and mixed (n=10) type, was 88.2±121.2 mg/dL, whereas in the homogeneous group, including high density (n=2), isodensity (n=9), and low density (n=6) types, it was <25 mg/dL. The concentration of fibrinogen was significantly higher in the heterogeneous group than in the homogeneous group (p=0.006). The mean level of D-dimer in the heterogeneous group was 35,407.9±16,325.5 μg/L, whereas for the homogeneous group it was 1476.4±2091.4 μg/L. The concentration of D-dimer was significantly higher in the heterogeneous group than in the homogeneous group (p<0.001).

Conclusions: The layering and mixed types of CSDH exhibited higher concentrations of fibrinogen and D-dimer in subdural hematoma than the homogeneous types. These fibrinolytic factors appear to be associated with evolution in CSDHs with heterogeneous density.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / therapeutic use
  • Antifibrinolytic Agents / therapeutic use
  • Brain / diagnostic imaging
  • Drainage
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Fibrin Fibrinogen Degradation Products / physiology
  • Fibrinogen / analysis*
  • Fibrinogen / physiology
  • Hematoma, Subdural, Chronic / blood*
  • Hematoma, Subdural, Chronic / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Prospective Studies
  • Therapeutic Irrigation
  • Tomography, X-Ray Computed

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Antifibrinolytic Agents
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • Fibrinogen