Exploring the Key Pathogenesis of Chronic Subdural Hematoma Based on the Theory of Essence Deficiency and Collateral Damage

LI Kai; FAN Xiaoxuan; LIU Kexin; LIU Xue; LIU Yunlin; FENG Yin

doi:10.26950/j.issn.2097-5031.2025.04.008

Abstract：Chronic subdural hematoma(CSDH)is a high incidence nervous system disease in the elderly.Its incidence rate increases significantly with age,and the incidence rate of people over 70 years old reaches 76.5～127.1 million.The traditional view is that CSDH is mainly caused by ruptured bridging veins due to head trauma,but about 30%to 50%of patients have no clear history of trauma,indicating that aging and related vascular degenerative diseases play a central role in the pathogenesis.According to traditional Chinese medicine theory,kidney essence is the material basis of life activities,mainly responsible for growth and development,as well as the filling of the marrow sea.During the aging process,the kidney essence gradually decreases,the qi and blood flow are insufficient,and the marrow sea is not nourished,resulting in the loss of brain collaterals,weak absorption,and blood overflowing outside the veins to form hematomas.At the same time,depletion of kidney essence can lead to qi stagnation and blood stasis,internal generation of phlegm turbidity,and further damage to collaterals,forming a vicious cycle of"deficiency stasis damage".This article is based on the theory of"essence deficiency and collateral damage"in traditional Chinese medicine,and systematically explores the impact of kidney essence deficiency and its resulting collateral damage on CSDH during the aging process.It proposes that the onset of CSDH may be the result of the combined effects of aging-related kidney essence deficiency and collateral damage.At the same time,starting from the integrated traditional Chinese medicine treatment strategy of tonifying the kidney and nourishing essence,removing blood stasis,and solidifying collaterals,a new approach has been provided for the prevention and treatment of elderly CSDH by regulating vascular homeostasis and inhibiting pathological leakage.