OBJECTIVETo probe into the incidence, mechanism and clinical characteristics of chronic subdural hematoma (CSDH) evolving from traumatic subdural effusion (TSE).

METHODSThe clinical materials of 32 patients with CSDH evolving from TSH were analyzed retrospectively and the correlative literature was reviewed.

RESULTS16.7% of the patients with TSH evolved into CSDH. The time of evolution was 22 - 100 days after head injury. All patients were cured with hematoma drainage.

CONCLUSIONSTSE is one of the origins of CSDH. The clinical characteristics of TSE evolving into CSDH include polarization of patient age, and chronic small effusion. The patients are usually injured deceleratedly and accompanied with mild cerebral damage.

Adolescent ; Adult ; Child ; Child, Preschool ; Chronic Disease ; Female ; Hematoma, Subdural ; etiology ; Humans ; Infant ; Male ; Middle Aged ; Retrospective Studies ; Subdural Effusion ; physiopathology ; Wounds and Injuries ; physiopathology

An in vitro blood-brain barrier (BBB) model is critical for enabling rapid screening of the BBB permeability of the drugs targeting on the central nervous system. Though many models have been developed, their reproducibility and renewability remain a challenge. Furthermore, drug transport data from many of the models do not correlate well with the data for in vivo BBB drug transport. Induced-pluripotent stem cell (iPSC) technology provides reproducible cell resources for in vitro BBB modeling. Here, we generated a human in vitro BBB model by differentiating the human iPSC (hiPSC) line GM25256 into brain endothelial-type cells. The model displayed BBB characteristics including tight junction proteins (ZO-1, claudin-5, and occludin) and endothelial markers (von Willebrand factor and Ulex), as well as high trans-endothelial electrical resistance (TEER) (1560 Ω.cm ± 230 Ω.cm) and γ-GTPase activity. Co-culture with primary rat astrocytes significantly increased the TEER of the model (2970 Ω.cm to 4185 Ω.cm). RNAseq analysis confirmed the expression of key BBB-related genes in the hiPSC-derived endothelial cells in comparison with primary human brain microvascular endothelial cells, including P-glycoprotein (Pgp) and breast cancer resistant protein (BCRP). Drug transport assays for nine CNS compounds showed that the permeability of non-Pgp/BCRP and Pgp/BCRP substrates across the model was strongly correlated with rodent in situ brain perfusion data for these compounds (R = 0.982 and R = 0.9973, respectively), demonstrating the functionality of the drug transporters in the model. Thus, this model may be used to rapidly screen CNS compounds, to predict the in vivo BBB permeability of these compounds and to study the biology of the BBB.