A Clinicopathologic Study Of Chronic Subdural Haemorrhage With Special Emphasis On Cox–2 And Vegf Expression

ABSTRACT

Introduction: Chronic subdural haemorrhage is known for high recurrence rates. Recently, VEGF and COX2 have been implicated as causal agents for recurrences, which can be targeted to prevent repeated surgeries and reduce morbidity. Material and Methods: Retrospective study including all cases (n=40) of chronic subdural haemorrhage from 2013 to 2017. The membranes were classified into four histologic subtypes. COX 2 and VEGF antibodies were applied on all cases. Ap value of <0.05 was considered statistically significant. Results: Four subtypes were type 1 non inflammatory (22.5%), type 2 inflammatory (20%), type 3 haemorrhagic inflammatory (27.5%) and type 4 scar inflammatory (30%). Glasgow coma score less than 13 (30%), maximum mean thickness of subdural haemorrhage (6.88), highest VEGF positivity rate (100%) and highest COX 2 positivity rate (91.67%) were found in type 4 membrane [p value 0.003 and 0.0001]. Conclusion:We found that type 4 membranes had worst Glasgow coma score, maximum thickness on CT, highest positivity for VEGF and COX2. Therefore, these are likely to have maximum recurrences and hence can be targeted for anti COX 2 and VEGF therapy.