title: Glycosaminoglycans in subdural fluid and CSF after meningeal injury.
abstract: BACKGROUND
  Inflammatory mechanisms have an acknowledged role in the progression of chronic subdural hematoma (CSDH) and in tissue response after subarachnoid hemorrhage (SAH). The participation of extracellular matrix, especially glycosaminoglycans, in the cellular events during tissue repair is known to be important. We studied the production of glycosaminoglycans after two types of meningeal injury-one caused by rupture of the dural border cell layer after head injury, and the other caused by SAH.
  
  
  METHODS
  Patients with CSDH (n = 28), subdural effusion (n = 8), and SAH (n = 33) were included in the study. Samples from subdural fluid or cerebrospinal fluid (CSF) were assayed for hyaluronic acid (HA) with an enzyme-linked assay and for sulfated glycosaminoglycans (sGAGs) with a dye-binding assay.
  
  
  RESULTS
  The median HA concentration was 3021 (range, 408-14,012) ng/ml in the CSDH fluid, 668 (392-3607) ng/ml in the effusion fluid, and 21.7 (5.8-195) ng/ml in the serum. In lumbar CSF after SAH, the median HA concentration was 246 (47-3686) ng/ml being 1.5-fold higher than that in control CSF. The median sGAG concentration was 52.8 (0-144) μg/ml in CSDH fluid, but only 5.32 (0-20.5) μg/ml in the effusion fluid, where the concentration was similar to that in the serum.
  
  
  CONCLUSIONS
  We found high, but variable, concentrations of sGAGs and HA in the CSDH and effusion fluid after head injury and HA in the CSF after SAH. Our results show that HA and sGAGs are induced after meningeal injury and that these proteins may participate in a reactive process.
authors.affiliation: Division of Clinical Neuroscience, Neurosurgery, University of Oulu, 90014, Oulu, Finland. anna-leena.heula@oulu.fi.|Department of Neurosurgery, Oulu University Hospital, Oulu, Finland. anna-leena.heula@oulu.fi.|Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. anna-leena.heula@oulu.fi.|Division of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland. anna-leena.heula@oulu.fi.|Department of Neurology, Oulu University Hospital, Oulu, Finland. anna-leena.heula@oulu.fi.
authors.forename: Anna-Leena
authors.initials: AL
authors.lastname: Heula
authors.affiliation: Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.|Division of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland.|Department of Neurology, Oulu University Hospital, Oulu, Finland.|Department of Surgery and Department of Neurology, Seinäjoki Central Hospital, Seinäjoki, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Sajanti
authors.affiliation: Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. kari.majamaa@oulu.fi.|Division of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland. kari.majamaa@oulu.fi.|Department of Neurology, Oulu University Hospital, Oulu, Finland. kari.majamaa@oulu.fi.
authors.forename: Kari
authors.initials: K
authors.lastname: Majamaa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006259:Craniocerebral Trauma; D018450:Disease Progression; D005260:Female; D006025:Glycosaminoglycans / Q000134:cerebrospinal fluid*; D020200:Hematoma, Subdural, Chronic / Q000134:cerebrospinal fluid* / Q000601:surgery; D006801:Humans; D006820:Hyaluronic Acid / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid* / Q000601:surgery; D013353:Subdural Effusion / Q000134:cerebrospinal fluid* / Q000601:surgery
chemical_list: D006025:Glycosaminoglycans; C013786:A73025; D006820:Hyaluronic Acid
keywords: Extracellular matrix; Fibrosis; Glycosaminoglycan; Meninges