A Comparative Study of the Capsular Vessels of Acute Subdural Hematoma in the Chronic Healing Stage and Those of Chronic Subdural Hematoma

摘要

A comparative study was made of the capsular vessels of acute subdural hematoma in its chronic healing stage and those of chronic subdural hematoma.In acute subdural hematoma in the chronic healing stage, the capsular vessels were formed secondary to hematoma. Microscopically, they were often streamlined with perivascular lymphocytic cuffings. They had scant blood components and demonstrated almost no perivascular hemorrhage. Electronmicroscopically, the endothelial cells were thick with numerous swollen mitochondria, enlarged rough endoplasmic reticula and free ribosomes. The capsular vessels seemed to be tight, as the endothelial cells were coated by fibrinoid material and had numerous tight junctions.In the chronic subdural hematoma, the capsular vessels or sinusoids were formed preceding hematoma. Microscopically, their lumina showed balloon-like enlargement and were surrounded by flattened endothelial cells. They had both perivascular hemorrhage and accumulation of various inflammatory cells. Electronmicroscopically, the endothelial cells were thinner and some had clear cytoplasms. Most characteristic was the frequency of endothelial gap junctions. The sinusoids seemed to be fragile, playing an important role in the enlargement of this hematoma.