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Journal of Korean Neurosurgical Society 1980;9(2): 377-386.
Experimental Study of Chronic Subdural Hematoma.
Dong Hyun Park, Suk Hong Han, Jung Hyun Woo
Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
In human and dog the blood clot formed in the presence of cerebrospinal fluid and incubated at 37-37. 5degrees C for 24 hours, was inoculated in the subdural space and abdominal subcutaneous tissue of dog homogenously, and in human abdominal subcutaneous tissue autogenously. The chronological change of these inoculated blood clots was investigated and histological study was performed in cases with evolusion comparable to human chronic subdural hematoma. Following results were obtained. 1) In both human and dog, the blood clot formed by mixture of fresh blood and cerebrospinal fluid and inoculation for 24 hours was surrounded by elastic membranous structure which was histologically proved to be composed of delicate fibrin network. 2) In the animals inoculated with pure blood clot in subdural space, this clot regressed and was absorbed. 3) In the animals inoculated in subdural space with the blood clot formed in presence of cerebrospinal fluid. Inoculated clot grew gradually and was encapsulated and liquefied 1 week after inoculation. The wall of the older hematoma was thicker and was more infiltrated with neovascularization than that of young hematoma. 4) In animal experiment for subcutaneous inoculation with blood clot, formed with mixing cerebrospinal fluid progressed to hematoma comparable to human chronic subdural hematoma. On other hand, in experiment using pure blood clot no hematoma developed. 5) With no difference in clots formed under either presence of C.S.F. or absence of it, all blood clots inoculated in human subcutaneous tissue were absorbed within a few days and changed to the granulation tissue. Thus it was inferred that the C.S.F. was closely related to induce the capsule formation of chronic subdural hematoma.
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