Haem derivatives in subdural haematomas.
The oxyhaemoglobin, methaemoglobin and bilirubin concentrations were determined in subdural haematomas and cerebrospinal fluid from 18 patients. The total haem derivative concentration ranged from 55 mumol/l to 13.9 mmol/l in the haematomas and from 0.1 mumol/l to 8.2 mumol/l in the cerebrospinal fluid. Bilirubin was the dominating fraction in haematomas with haem derivative concentrations lower than 1 mmol/l. For haematomas exceeding this value, the bilirubin transforming capacity seemed to have reached a maximum. More of the oxyhaemoglobin was oxidized to methaemoglobin in these cases, a reaction known to release superoxide radicals. The possible pathophysiological significance hereof, e.g. in cerebral vasospasm, is discussed.