Fatty acid composition of the chronic subdural hematoma: with reference to its recurrence.

The fatty acid composition of aspirated chronic subdural hematoma (CSDH) was measured by gas liquid chromatography and the relationship between fatty acid and recurrence of the hematoma was assessed. Thirty patients with CSDH were operated on through a single burr-hole; 4 patients developed recurrent hematoma (13%). The lipid composition of CSDH was mainly phosphatidylcholine, sphingomyelin, cholesterol, free fatty acid, triacylglycerol and cholesterol ester. The fatty acid constituents were palmitic, stearic, oleic, linoleic, arachidonic and docosahexanoeic acids. Analysis of the polyunsaturated fatty acids demonstrated that hematoma taken from patients with recurrent CSDH contained more linoleic acid (n-6) than those with non-recurrent CSDH. Linoleic and arachidonic acids are known to induce angiogenesis in cultured aortic endothelial cells. Change in fatty acid composition of recurrent hematoma might be associated with rebleeding from the hematoma capsule.