Fibrinogen and D-dimer analysis of chronic subdural hematomas and computed tomography findings: a prospective study.

Abstract Objective We investigated the relationship between fibrinolytic factors and computed tomography (CT) findings in patients with chronic subdural hematomas (CSDHs). Methods Thirty-one patients with CSDHs were divided on the basis of CT findings into heterogeneous and homogeneous groups. A sample from the subdural hematoma was obtained at surgery to measure the concentrations of fibrinogen and D-dimer. Results The mean level of fibrinogen in the heterogeneous group, including the layering ( n  = 4) and mixed ( n  = 10) type, was 88.2 ± 121.2 mg/dL, whereas in the homogeneous group, including high density ( n  = 2), isodensity ( n  = 9), and low density ( n  = 6) types, it was p  = 0.006). The mean level of D-dimer in the heterogeneous group was 35,407.9 ± 16,325.5 μg/L, whereas for the homogeneous group it was 1476.4 ± 2091.4 μg/L. The concentration of D-dimer was significantly higher in the heterogeneous group than in the homogeneous group ( p Conclusions The layering and mixed types of CSDH exhibited higher concentrations of fibrinogen and D-dimer in subdural hematoma than the homogeneous types. These fibrinolytic factors appear to be associated with evolution in CSDHs with heterogeneous density.