The involvement of
inflammation in the development and propagation of chronic subdural haematoma (CSH) was investigated by measuring the levels of inflammatory
cytokines (tumour
necrosis factor [
TNF] alpha,
interleukin [IL]-1 beta, IL-6, and IL-8). Peripheral venous blood and subdural fluid were obtained at the time of burr hole surgery from 34 patients with CSH and from 9 with
subdural effusion. The levels of the inflammatory
cytokines were analysed by
enzyme-linked
immunosorbent assay. The blood levels of
TNF alpha,
IL-1 beta,
IL-6, and
IL-8 in both CSH and
subdural effusion groups were almost within the range of normal subjects, and no differences were observed between the two groups.
IL-6 and
IL-8 in the subdural fluid were much higher than in the blood of both groups, and the levels in CSH patients were significantly higher (10 times) than in
subdural effusion patients. Local elevation of inflammatory
cytokines in the subdural space of both CSH and
subdural effusion without systemic change suggests the presence of local
inflammation in the two diseases. The same behavioural patterns of
cytokines for these and higher levels of
cytokines in the CSH also suggest that inflammatory
cytokines may be involved in the continuous development from
subdural effusion to CSH and propagation of CSH.