Role of macrophages in outer membrane of Chronic Subdural Hematoma

Abstract

Abstract Background Chronic subdural hematoma (CSDH) is a common disease in the field of neurosurgery. Previous studies show that the outer membrane of CSDH is divided into four histological stages by HE staining and elasticavan Gieson staining. However, this method cannot show the proportion of specific inflammatory cell components at different stages. This study aims to explore the major inflammatory cells in the outer membrane of CSDH and discussion their function in CSDH. Methods A total of 18 patients were included in this study. A semi-quantitative analysis was performed on the results of Hematoxylin-eosin (HE), immunohistochemistry and Masson staining. Results Analysis results show, in stage II, that macrophages make up the highest number of inflammatory cells, followed by T cells, B cells and neutrophil. Eosinophil main express at stage II and stage III. Interestingly, Inflammatory cells in the outer membrane are arranged in this order at any stage. In stage III, the expression number of CD31 is more than in stage II. Masson staining shows that neomembrane fibrosis gradually increases from stage I to stage IV. The expression of Transforming growth factor β(TGF-β) in the outer membrane correlates with the expression of CD68 in neomembrane (R2 = 0.810, P = 0.015). Conclusion The external membrane of CSDH may be a process of formation of scarring membrane according to the results of inflammatory elements in the outer membrane. The formation and development of the outer membrane of CSDH changes dynamically, macrophages play an important role in inflammation, neocapillaries and fibrosis, we considered macrophages play a critical role in the development of CSDH.