Physiopathogenesis of subdural hematomas

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Abstract
The dorsal s.c. injection in rats of 12 ml or more of autologous hemolyzed whole blood clotted in situ induced the formation of sterile, hemispheric lesions, 47% of which showed an initial decrease in volume followed by progressive enlargement. The behavior, histology and biochemical characteristics of the liquid contents of these lesions were remarkably similar to those of subdural hematomas in man. To evaluate the role of the various blood components that may have influenced the formation and growth of these lesions, more than 150 clots composed of human platelet-free plasma, autologous hemolyzed blood or autologous whole blood were implanted s.c. in rats by either surgical or injection techniques. The in vitro behavior of the different clots used was assessed. The composition and vol of the clots appeared to be critical variables. Plasma-fibrin provided the matrix shape of the lesions while breakdown products derived from erythrocytes, Hb, leukocytes and other solid blood elements induced neomembrane formation and contributed to the lesion''s subsequent growth. Inflammation mechanisms appeared to be essential but CSF played no discernible role in the process.
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