Evidence map›Paper›PMID 36854960›Full record

ArticleScientific reports2023

Cortical atrophy in chronic subdural hematoma from ultra-structures to physical properties.

Pietro Familiari, Pierfrancesco Lapolla, Michela Relucenti, Ezio Battaglione, Loredana Cristiano, Veronica Sorrentino, Sara Aversa, Alessia D'Amico, Pierfabrizio Puntorieri, Lucia Bruzzaniti and 12 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 5 institutions in 2 countries.

Pietro Familiari *Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Pierfrancesco Lapolla *Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Oxford University Hospital, Headington, Oxford, OX3 9DU, UK. pierfrancesco.lapolla@nds.ox.ac.uk.
Michela RelucentiDepartment of Anatomical, Histological, Medical Legal Sciences and Locomotor Apparatus, Sapienza University of Rome, Rome, Italy.
Ezio BattaglioneDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
Loredana CristianoDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Veronica SorrentinoDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
Sara AversaDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
Alessia D'AmicoDepartment of Experimental Medicine, Sapienza, University of Rome, Rome, Italy.
Pierfabrizio PuntorieriDICEAM Department, University Mediterranea of Reggio Calabria, Reggio Calabria, Italy.
Lucia BruzzanitiDICEAM Department, University Mediterranea of Reggio Calabria, Reggio Calabria, Italy.
Andrea MingoliDepartment of Surgery "Pietro Valdoni", Sapienza University of Rome, Rome, Italy.
Gioia BrachiniDepartment of Surgery "Pietro Valdoni", Sapienza University of Rome, Rome, Italy.
Giuseppe BarbaroDICEAM Department, University Mediterranea of Reggio Calabria, Reggio Calabria, Italy.
Anthony Kevin ScafaDepartment of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Giancarlo D'AndreaNeurosurgery Division of "Spaziani" Hospital, Frosinone, Italy.
Alessandro FratiDepartment of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Veronica PicottiDepartment of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Luigi Valentino BerraDepartment of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Vincenzo PetrozzaDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
Stefania NottolaDepartment of Anatomical, Histological, Medical Legal Sciences and Locomotor Apparatus, Sapienza University of Rome, Rome, Italy.
Antonio Santoro *Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Placido Bruzzaniti *Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Sapienza University of Rome · ITUniversity of Reggio Calabria · ITJohn Radcliffe Hospital · GBPoliclinico Tor Vergata · ITUniversity of L'Aquila · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Several theories have tried to elucidate the mechanisms behind the pathophysiology of chronic subdural hematoma (CSDH). However, this process is complex and remains mostly unknown. In this study we performed a retrospective randomised analysis comparing the cortical atrophy of 190 patients with unilateral CSDH, with 190 healthy controls. To evaluate the extent of cortical atrophy, CT scan images were utilised to develop an index that is the ratio of the maximum diameter sum of 3 cisterns divided by the maximum diameter of the skull at the temporal lobe level. Also, we reported, for the first time, the ultrastructural analyses of the CSDH using a combination of immunohistochemistry methods and transmission electron microscopy techniques. Internal validation was performed to confirm the assessment of the different degrees of cortical atrophy. Relative Cortical Atrophy Index (RCA index) refers to the sum of the maximum diameter of three cisterns (insular cistern, longitudinal cerebral fissure and cerebral sulci greatest) with the temporal bones' greatest internal distance. This index, strongly related to age in healthy controls, is positively correlated to the preoperative and post-operative maximum diameter of hematoma and the midline shift in CSDH patients. On the contrary, it negatively correlates to the Karnofsky Performance Status (KPS). The Area Under the Receiver Operating Characteristics (AUROC) showed that RCA index effectively differentiated cases from controls. Immunohistochemistry analysis showed that the newly formed CD-31 positive microvessels are higher in number than the CD34-positive microvessels in the CSDH inner membrane than in the outer membrane. Ultrastructural observations highlight the presence of a chronic inflammatory state mainly in the CSDH inner membrane. Integrating these results, we have obtained an etiopathogenetic model of CSDH. Cortical atrophy appears to be the triggering factor activating the cascade of transendothelial cellular filtration, inflammation, membrane formation and neovascularisation leading to the CSDH formation.

Indexed as

Hematoma, Subdural, ChronicNeurodegenerative DiseasesAtrophyFiltrationHumansInflammationPhysical PhenomenaRetrospective Studies

Identifiers

PMID36854960
PMCPMC9975247
OpenAlexW4322718761

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.