[Physiopathology of chronic subdural hematoma].
Coagulation, fibrinolysis and kinin-kallicrein system disorders could explain chronic subdural hematoma pathophysiology. The marked decrease in antithrombin III in the hematoma suggest that the decreased levels of clotting factors were caused by excessive coagulation resulting in clotting factors consumption. The decrease in alpha 2-antiplasmin with the increase of fibrin degradation products suggest that hyperfibrinolytic activity of the subdural hematoma. Coagulation and fibrinolysis disorders could explain repetitive hemorrhages from the outer membrane, which cause progressive enlargement of the hematoma. Kinin-kallicrein system disorders raise the hemorrhage by its action on the outer membrane. Nowadays, the earliest osmotic theory should reasonably be abandoned.
Cuny
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Clinique Universitaire de Neurochirurgie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie-Raba-Léon, 33076 Bordeaux. emmanuel.cuny@chu-bordeaux.fr
D001779:Blood Coagulation Factors / Q000378:metabolism*; D005342:Fibrinolysis / Q000502:physiology*; D020200:Hematoma, Subdural, Chronic / Q000097:blood*; D006801:Humans; D016234:Kallikrein-Kinin System / Q000502:physiology
D001779:Blood Coagulation Factors
Physiopathologie de l'hématome sous-dural chronique.