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    Pregnancy-Associated Plasma Protein A and High-Sensitivitive C-Reactive Protein Levels in Chronic Subdural Haematoma Patients
    (Journal Neurological Sciences, 2011) Hanımoğlu, Hakan; Ulu, Mustafa Onur; Biçeroğlu, Hüseyin; Memişoğulları, Ramazan; Coşkun, Abdurrahman; Balak, Naci; Uzan, Mustafa
    Objective: Pregnancy-associated plasma protein A (PAPP-A), a metalloproteinase that regulates insulinlike growth factor-1 bioavailability in vitro, has been suggested to play an active role in the pathophysiology of several conditions involving inflammatory responses. We investigated the values of PAPP-A and high sensitive CRP (hsCRP) levels in chronic subdural haematoma (CSDH) patients and healthy controls. Methods: PAPP-A and hsCRP levels were studied in the serum and subdural haematoma fluid of 20 consecutive patients with CSDHs (M / F: 12 / 8; mean age of 56.7) and in the serum of age matched 16 volunteers (M / F: 10 / 6; mean age: 54,2). Results: The serum PAPP-A [4.15 ng/mL (2.70-12.88)] levels of patients were significantly lower than control group [9.32 ng/mL (6.57 - 17.00)] (p< 0.01) and the hsCRP levels were significantly higher in patient group [4.57 mg/L (1.56 - 12.62)] (p< 0.01). The comparison of PAPP-A values in the serum and subdural haematoma in the patient group revealed significantly very high values in the subdural fluid [204.5 ng/mL (161.1 - 261.4)] than the serum [4.15 ng/mL (2.70-12.88)] (p < 0.0001). The hsCRP values, on the other hand, were significantly lower in the subdural haematoma fluid than the serum in the patient group (p = 0.016). Conclusion: PAPP-A may have an important function in the local inflammatory events and local structural changes associated with CSDH formation and growth. The detection of high peripheral hsCRP levels in the patient group suggests that a systemic inflammatory response follows after the traumatic insult leading to CSDH formation.