51
|
Çavdar S, Solmaz B, Taniş Ö, Guler OU, Dalçık H, Aydoğmuş E, Altunkaya L, Kara E, Aslıyüksek H. Anatomic variations of the human falx cerebelli and its association with occipital venous sinuses. Br J Neurosurg 2020; 35:306-312. [PMID: 32781846 DOI: 10.1080/02688697.2020.1793907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Human falx cerebelli is an important anatomical structure in regard to its relations with venous structures during infratentorial approach to reach cerebellar tumors, vascular malformations, traumatic hemorrhage and Chiari malformations. The present study aim to describe the different types of variations of the falx cerebelli, its morphological features and its association with occipital venous sinuses. METHOD In this study 49 dura mater was obtained from the Institution of Forensic Medicine. The length, width and the depth of the falx cerebelli were measured using a digital compass. The data obtained were statistically analyzed in relation to age and gender. The relations of the falx cerebelli with the occipital sinus was documented. Histological sections from the falx cerebelli were stained with Hematoxylin Eosin to evaluate the fine structure. RESULTS Among the 49 falx cerebelli examined 36 (73.5%) were classified as normal. The average length, width and depth of the normal falx cerebelli was 3.7, 1.0 and 0.4 cm respectively. Of the 49 falx cerebelli in 1 (2%) case it was absent, in 5 cases (10.2%) duplicate, in 5 cases (10.2%) triplicate, in 1 (2%) case quadruplets and in 1 case (2%) it was five-folded. The proximal and the distal attachments of the falx cerebelli showed 3 types of variations; both attachments triangular, the proximal attachments triangular and the distal ramified and distal attachments triangular and the proximal attachments ramified. The drainage of the occipital sinus of falx cerebelli with variations were evaluated. The increased number of falx cerebelli highly corresponded with the increased number of occipital sinus. CONCLUSIONS The dural-venous variation in the posterior cranial fossa can be problematic in various diagnostic and operative procedures of this region. Neurosurgeons should be aware of such variations, as these could be potential sources of haemorrhage during the midline suboccipital and infratentorial approaches.
Collapse
Affiliation(s)
- Safiye Çavdar
- Department of Anatomy, Koç University, School of Medicine, Istanbul, Turkey
| | - Bilgehan Solmaz
- Department of Neurosurgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Özgül Taniş
- Department of Anatomy, Koç University, School of Medicine, Istanbul, Turkey
| | - Orhan Ulas Guler
- Department of Anatomy, Koç University, School of Medicine, Istanbul, Turkey
| | - Hakkı Dalçık
- Department of Histology Embryology, Aydın University, School of Medicine, Istanbul, Turkey
| | - Evren Aydoğmuş
- Department of Neurosurgery, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | - Leyla Altunkaya
- Department of Anatomy, Koç University, School of Medicine, Istanbul, Turkey
| | | | | |
Collapse
|
52
|
Bi X, Liu B, Mao Z, Wang C, Dunne N, Fan Y, Li X. Applications of materials for dural reconstruction in pre-clinical and clinical studies: Advantages and drawbacks, efficacy, and selections. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 117:111326. [PMID: 32919680 DOI: 10.1016/j.msec.2020.111326] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/26/2020] [Accepted: 07/30/2020] [Indexed: 12/29/2022]
Abstract
The dura mater provides a barrier to protect the tissue underneath and cerebrospinal fluid. However, dural defects normally cause cerebrospinal fluid leakage and other complications, such as wound infections, meningitis, etc. Therefore, the reconstruction of dura mater has important clinical significance. Current dural reconstruction materials include: homologous, acellular, natural, synthetic, and composite materials. This review comprehensively summarizes the characteristics and efficacy of these dural substitutes, especially in clinical applications, including the advantages and drawbacks of those from different sources, the host tissue response in pre-clinical studies and clinical practice, and the comparison of these materials across different surgical procedures. Furthermore, the selections of materials for different surgical procedures are highlighted. Finally, the challenges and future perspectives in the development of ideal dural repair materials are discussed.
Collapse
Affiliation(s)
- Xuewei Bi
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Bo Liu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Zhinan Mao
- International Research Center for Advanced Structural and Biomaterials, School of Materials Science & Engineering, Beihang University, Beijing 100191, China
| | - Cunyang Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Nicholas Dunne
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Stokes Building, Collins Avenue, Dublin 9, Ireland
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China.
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China.
| |
Collapse
|
53
|
Tsutsui T, Yamao Y, Yoshida K, Komura S, Arakawa Y, Kataoka H, Miyamoto S. A Rare Case of Schwannoma Arising from the Dura Mater of the Petrosal Surface in the Posterior Cranial Fossa. World Neurosurg 2020; 141:188-191. [PMID: 32569764 DOI: 10.1016/j.wneu.2020.06.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND An intracranial schwannoma originating in the dura mater is extremely rare. Herein, we report a case of schwannoma arising from the dura mater of the petrosal surface in the posterior cranial fossa. CASE DESCRIPTION A 48-year-old man presented with slight gait disturbance and papilledema. Magnetic resonance imaging showed a T1- and T2-weighted mixed-intensity extra-axial tumor, approximately 4 cm in the maximum diameter with multiple small cysts, in the left posterior cranial fossa. The tumor was heterogeneously enhanced with gadolinium. Operative findings via a lateral suboccipital approach revealed that the tumor did not adhere to any cranial nerves but to the dura mater of the petrosal surface. The tumor was completely excised without any neurologic deficits, and the histologic diagnosis was schwannoma. CONCLUSIONS The operative and postoperative findings suggested that the schwannoma originated in the meningeal branch of the lower cranial nerves or upper cervical nerves in the dura mater of the petrosal surface in the posterior cranial fossa.
Collapse
Affiliation(s)
- Takeyoshi Tsutsui
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Shouichi Komura
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
54
|
Toma N. Embryology of the Cavernous Sinus and Relevant Veins. JOURNAL OF NEUROENDOVASCULAR THERAPY 2020; 14:540-546. [PMID: 37502138 PMCID: PMC10370656 DOI: 10.5797/jnet.ra.2020-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/03/2020] [Indexed: 07/29/2023]
Abstract
The cavernous sinus (CS) is a parasellar dural envelope containing an important venous pathway. The venous channels, which have an endothelial layer and no smooth muscle layer, are located in connective tissue. In the early embryonic stages, the neural tube is surrounded by the primitive capillary plexus and undifferentiated mesenchymal tissue, the primary meninx, and initially drains into the primary head sinus (PHS) through the anterior, middle, and posterior dural plexus (ADP, MDP, and PDP). Subsequently, following enlargement of the brain and differentiation of the mesenchyme, two major primary sinuses, the pro-otic sinus and the primitive tentorial sinus, become prominent. The pro-otic sinus is the remnant of the short segment of the PHS cranial to the MDP and the stem of the MDP. The CS originates from the plexiform channels medial to the trigeminal ganglion, namely the medial tributaries of the pro-otic sinus. The stem of the pia-arachnoidal vein draining into the ADP represents the primitive tentorial sinus. It is considerably elongated due to expansion of the cerebral hemisphere, and migrates medially toward the CS. The morphological changes in the CS and primitive tentorial sinus exhibit considerable variation in cerebral venous drainage patterns. Embryological knowledge facilitates interpretation of the anatomy of the CS, and it is useful to perform safe and beneficial endovascular treatment for the CS.
Collapse
Affiliation(s)
- Naoki Toma
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| |
Collapse
|
55
|
Murase M, Tamura R, Kuranari Y, Sato M, Ohara K, Morimoto Y, Yoshida K, Toda M. Novel histopathological classification of meningiomas based on dural invasion. J Clin Pathol 2020; 74:238-243. [PMID: 32546547 DOI: 10.1136/jclinpath-2020-206592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 11/03/2022]
Abstract
AIMS Histological invasion into the adjacent brain parenchyma is frequently investigated in meningioma because it is an important morphological criterion for grade II meningioma according to the 2016 WHO classification. However, few studies have focused on dural invasion of meningiomas. Herein, we propose a novel histopathological classification based on dural invasion of meningiomas. METHODS Forty-nine cases with WHO grade I meningiomas who underwent Simpson grade I removal were collected. After the meningeal layer (ML) and periosteal layer (PL) of dura mater were visualised by Masson's trichrome stain, we evaluated the depth (to the ML and PL) and the patterns (1, expanding; 2, infiltrating) of dural invasion of meningiomas using serial paraffin sections. Invasion-associated markers, including Ki-67, matrix metalloproteinase (MMP)-1, MMP-9 and MMP-13, aquaporin 1 and Na-K-2Cl cotransporter, were quantitatively analysed by immunohistochemistry. RESULTS Thirty-five cases (71.4%) showed the dural invasion. In 27 of these 35 cases (77.1%), dural invasion was localised in ML. Type 1 (expanding type) and type 2 (infiltrating type) invasions were observed in 23 and 12 cases, respectively. The recurrence rate in cases with type 2 invasion was significantly higher than that in cases with type 1 invasion. The percentage of MMP-1-positive tumour cells was also significantly higher in cases with dural invasion than those without, suggesting involvement of MMP-1 in dural invasion. CONCLUSIONS We quantitatively evaluated the depth and patterns of dural invasion in meningiomas. The patterns of dural invasion were associated with meningioma recurrence.
Collapse
Affiliation(s)
- Makoto Murase
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Ryota Tamura
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yuki Kuranari
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Mizuto Sato
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kentaro Ohara
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yukina Morimoto
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kazunari Yoshida
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Masahiro Toda
- Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|
56
|
Whitehead MT, Vezina G. The fetal falx cerebelli. Pediatr Radiol 2020; 50:984-989. [PMID: 32185447 DOI: 10.1007/s00247-020-04641-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/23/2019] [Accepted: 02/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The falx cerebelli is a retrocerebellar dural reflection. The MR spectrum of the fetal falx cerebelli has not been described. OBJECTIVE To determine the prevalence of falx cerebelli abnormalities in the context of posterior fossa malformations and compare them to age-matched normal fetal MRI exams. MATERIALS AND METHODS We reviewed all consecutive fetal MRIs performed over 1 year at a children's hospital. We assessed the falx cerebelli in each examination for location, morphology, size and number. Exams were grouped into (1) normal or non-brain/head abnormalities or (2) abnormal brain or craniofacial structures. We used chi square, linear regression and logistic regression analyses; P<0.05 was considered significant. RESULTS We included 424 examinations (223 controls, 201 malformations) from 378 patients (mean gestational age 27±6 weeks). In the control group, the mean falx size was 2.6±1.2 mm (anteroposterior) × 11.0±3.2 mm (craniocaudal), with 80% retrovermian centered; the falx was linear (23%), Y-shape (15%), V-shape (22%) or U-shape (21%); it was unusually multiplicated (17%) or absent (<2%). Falx cerebellar abnormalities were more common in abnormal exams (59%; 119/201) than in normal exams (19%; 43/223) (P<0.001). The falx was abnormal with Blake pouch cysts (9/9, 100%) and rhombencephalosynapsis (3/4, 75%), absent in all Chiari II (n=9) and most Dandy-Walker malformations (5/6, 83%), commonly multiplicated in mega cisterna magna (14/22, 64%), and deviated or absent in cases with arachnoid cysts (3/3, 100%) and adhesions (4/5, 80%). CONCLUSION Structural alterations of the falx cerebelli are more prevalent in fetuses with brain and craniofacial abnormalities. Specific changes offer clues to posterior fossa diagnoses.
Collapse
Affiliation(s)
- Matthew T Whitehead
- Department of Neuroradiology, Children's National Health System, 111 Michigan Ave. NW, Washington, DC, 20010, USA.
- George Washington University Hospital, Washington, DC, USA.
| | - Gilbert Vezina
- Department of Neuroradiology, Children's National Health System, 111 Michigan Ave. NW, Washington, DC, 20010, USA
- George Washington University Hospital, Washington, DC, USA
| |
Collapse
|
57
|
When is an incidental durotomy a complication during lumbar spine surgery? Spine J 2020; 20:685-687. [PMID: 32416875 DOI: 10.1016/j.spinee.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 02/03/2023]
|
58
|
Caspi Y, Brouwer RM, Schnack HG, van de Nieuwenhuijzen ME, Cahn W, Kahn RS, Niessen WJ, van der Lugt A, Pol HH. Changes in the intracranial volume from early adulthood to the sixth decade of life: A longitudinal study. Neuroimage 2020; 220:116842. [PMID: 32339774 DOI: 10.1016/j.neuroimage.2020.116842] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 03/04/2020] [Accepted: 04/06/2020] [Indexed: 01/09/2023] Open
Abstract
Normal brain-aging occurs at all structural levels. Excessive pathophysiological changes in the brain, beyond the normal one, are implicated in the etiology of brain disorders such as severe forms of the schizophrenia spectrum and dementia. To account for brain-aging in health and disease, it is critical to study the age-dependent trajectories of brain biomarkers at various levels and among different age groups. The intracranial volume (ICV) is a key biological marker, and changes in the ICV during the lifespan can teach us about the biology of development, aging, and gene X environment interactions. However, whether ICV changes with age in adulthood is not resolved. Applying a semi-automatic in-house-built algorithm for ICV extraction on T1w MR brain scans in the Dutch longitudinal cohort (GROUP), we measured ICV changes. Individuals between the ages of 16 and 55 years were scanned up to three consecutive times with 3.32±0.32 years between consecutive scans (N = 482, 359, 302). Using the extracted ICVs, we calculated ICV longitudinal aging-trajectories based on three analysis methods; direct calculation of ICV differences between the first and the last scan, fitting all ICV measurements of individuals to a straight line, and applying a global linear mixed model fitting. We report statistically significant increase in the ICV in adulthood until the fourth decade of life (average change +0.03%/y, or about 0.5 ml/y, at age 20), and decrease in the ICV afterward (-0.09%/y, or about -1.2 ml/y, at age 55). To account for previous cross-sectional reports of ICV changes, we analyzed the same data using a cross-sectional approach. Our cross-sectional analysis detected ICV changes consistent with the previously reported cross-sectional effect. However, the reported amount of cross-sectional changes within this age range was significantly larger than the longitudinal changes. We attribute the cross-sectional results to a generational effect. In conclusion, the human intracranial volume does not stay constant during adulthood but instead shows a small increase during young adulthood and a decrease thereafter from the fourth decade of life. The age-related changes in the longitudinalmeasure are smaller than those reported using cross-sectional approaches and unlikely to affect structural brain imaging studies correcting for intracranial volume considerably. As to the possible mechanisms involved, this awaits further study, although thickening of the meninges and skull bones have been proposed, as well as a smaller amount of brain fluids addition above the overall loss of brain tissue.
Collapse
Affiliation(s)
- Yaron Caspi
- UMC Utrecht Brain Center, Department of Psychiatry, University Medical Center Utrecht, the Netherlands.
| | - Rachel M Brouwer
- UMC Utrecht Brain Center, Department of Psychiatry, University Medical Center Utrecht, the Netherlands
| | - Hugo G Schnack
- UMC Utrecht Brain Center, Department of Psychiatry, University Medical Center Utrecht, the Netherlands
| | | | - Wiepke Cahn
- UMC Utrecht Brain Center, Department of Psychiatry, University Medical Center Utrecht, the Netherlands
| | - René S Kahn
- UMC Utrecht Brain Center, Department of Psychiatry, University Medical Center Utrecht, the Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wiro J Niessen
- Department of Radiology and Nuclear Medicine, Erasmus MC: University Medical Center Rotterdam, the Netherlands
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC: University Medical Center Rotterdam, the Netherlands
| | - Hilleke Hulshoff Pol
- UMC Utrecht Brain Center, Department of Psychiatry, University Medical Center Utrecht, the Netherlands.
| |
Collapse
|
59
|
Gandhi J, DiMatteo A, Joshi G, Smith NL, Khan SA. Cerebrospinal fluid leaks secondary to dural tears: a review of etiology, clinical evaluation, and management. Int J Neurosci 2020; 131:689-695. [PMID: 32242448 DOI: 10.1080/00207454.2020.1751625] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Damage to the dura mater often occurs in trauma cases of the head and spine, surgical procedures, lumbar punctures, and meningeal diseases. The resulting damage from dural tears, or durotomy, causes cerebrospinal fluid (CSF) to leak out into the surrounding space. The CSF leak induces intracranial hypotension, which can clinically present with a range of symptoms not limited to positional headaches which can confound accurate diagnosis. Current methods of evaluation and management of dural tears are discussed herewith, as well as the present understanding of its etiology, which may be classified as related to surgery, procedure, trauma, or connective tissue disorder. METHODS We piloted a MEDLINE® database search of literature, with emphasis on the previous five years, combining keywords such as "cerebrospinal fluid leak," "surgery," "procedure," and "trauma" to yield original research articles and case reports for building a clinical profile. RESULTS Patients with suspected dural tears should be evaluated based on criteria set by the International Headache Society, radiological findings, and a differential diagnosis to accurately identify the tear and its potential secondary complications. Afflicted patients may be treated promptly with epidural blood patches, epidural infusions, epidural fibrin glue, or surgical repair. At this time, epidural blood patches are the first line of treatment. Dural tears can be prevented to an extent by utilizing minimally invasive techniques and certain positions for lumbar puncture. Surgical, trauma, lumbar puncture, and epidural injection patients should be observed very carefully for dural tears and CSF leaks as the presenting clinical manifestations can be highly individualized and misguiding. CONCLUSION Because studies have demonstrated a high frequency of dural tears, particularly in spinal surgery patients, there is a need for prospective studies so that clinicians can develop an elaborate prevention strategy and response to avoid serious, unseen complications.
Collapse
Affiliation(s)
- Jason Gandhi
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Medical Student Research Institute, St. George's University School of Medicine, Grenada, West Indies
| | - Andrew DiMatteo
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Gunjan Joshi
- Department of Internal Medicine, Stony Brook Southampton Hospital, Southampton, NY, USA
| | | | - Sardar Ali Khan
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.,Department of Urology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
60
|
Suh DC. Where Did the Dura Mater Come from? Neurointervention 2020; 15:2-3. [PMID: 32093449 PMCID: PMC7105093 DOI: 10.5469/neuroint.2020.00045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 02/24/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
- Dae Chul Suh
- Neurointervention Clinic, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
61
|
Kinaci A, Bergmann W, Bleys RL, van der Zwan A, van Doormaal TP. Histologic Comparison of the Dura Mater among Species. Comp Med 2020; 70:170-175. [PMID: 32014084 DOI: 10.30802/aalas-cm-19-000022] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The biocompatibility, biodegradation, feasibility, and efficacy of medical devices like dural sealants and substitutes are often evaluated in various animal models. However, none of these studies explain the rationale for choosing a particular species, and a systematic interspecies comparison of the dura is not available. We hypothesized that histologic characteristics of the dura would differ among species. We systematically investigated basic characteristics of the dura, including thickness, composition, and fibroblast orientation of the dura mater, in 34 samples representing 10 animal species and compared these features with human dura by using hematoxylin and eosin staining and light microscopy. Dura showed many similarities between species in terms of composition. In all species, dura consisted of at least one fibrovascular layer, which contained collagen, fibroblasts, and blood vessels, and a dural border cell layer beneath the fibrovascular layer. Differences between species included the number of fibrovascular layers, fibroblast orientation, and dural thickness. Human dura was the thickest (564 μm) followed by equine (313 μm), bovine (311 μm), and porcine (304 μm) dura. Given the results of this study and factors such as gross anatomy, feasibility, housing, and ethical considerations, we recommend the use of a porcine model for dural research, especially for in vivo studies.
Collapse
Affiliation(s)
- Ahmet Kinaci
- Department of Neurology and Neurosurgery, Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Technology Institute, Utrecht, The Netherlands;,
| | - Wilhelmina Bergmann
- Division ofPathology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Ronald Law Bleys
- Department of Anatomy, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Albert van der Zwan
- Department of Neurology and Neurosurgery, Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Technology Institute, Utrecht, The Netherlands
| | - Tristan Pc van Doormaal
- Department of Neurology and Neurosurgery, Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Brain Technology Institute, Utrecht, The Netherlands; Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
62
|
Venous pathologies in paediatric neuroradiology: from foetal to adolescent life. Neuroradiology 2019; 62:15-37. [PMID: 31707531 DOI: 10.1007/s00234-019-02294-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/20/2019] [Indexed: 02/07/2023]
Abstract
The interpretation of cerebral venous pathologies in paediatric practice is challenging as there are several normal anatomical variants, and the pathologies are diverse, involving the venous system through direct and indirect mechanisms. This paper aims to provide a comprehensive review of these entities, as their awareness can avoid potential diagnostic pitfalls. We also propose a practical classification system of paediatric cerebral venous pathologies, which will enable more accurate reporting of the neuroimaging findings, as relevant to the underlying pathogenesis of these conditions. The proposed classification system comprises of the following main groups: arterio-venous shunting-related disorders, primary venous malformations and veno-occlusive disorders. A multimodal imaging approach has been included in the relevant subsections, with a brief overview of the modality-specific pitfalls that can also limit interpretation of the neuroimaging. The article also summarises the current literature and international practices in terms of management options and outcomes in specific disease entities.
Collapse
|
63
|
Eisová S, Píšová H, Velemínský P, Bruner E. Normal craniovascular variation in two modern European adult populations. J Anat 2019; 235:765-782. [PMID: 31236921 PMCID: PMC6742892 DOI: 10.1111/joa.13019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 01/06/2023] Open
Abstract
The vascular networks running into the meningeal layers, between the brain and braincase, leave imprints on the endocranial surface. These traces are visible in osteological specimens and skeletal collections, providing indirect evidence of vascular patterns in those cases in which bone remains are the only source of anatomical information, such as in forensic science, bioarchaeology and paleontology. The main vascular elements are associated with the middle meningeal artery, the venous sinuses of the dura mater, and the emissary veins. Most of these vascular systems have been hypothesized to be involved in endocranial thermal regulation. Although these traits deal with macroanatomical features, much information on their variation is still lacking. In this survey, we analyze a set of craniovascular imprints in two European dry skull samples with different neurocranial proportions: a brachycephalic Czech sample (n = 103) and a mesocephalic Italian sample (n = 152). We analyzed variation and distribution, correlation with cranial metrics, and sex differences in the dominance of the branches of the middle meningeal artery, the patterns of confluence of the sinuses, and the size of the emissary foramina. The descriptive statistics provide a reference to compare specimens and samples from different case studies. When compared with the Italian skulls, the Czech skulls display a greater dominance of the anterior branch of the middle meningeal artery and more asymmetric right-dominance of the confluence of the venous sinuses. There is no sex difference in the middle meningeal vessels, but males show a greater prevalence of the occipito-marginal draining system. Differences in the middle meningeal vessels or venous sinuses are apparently not influenced by cranial dimensions or proportions. The mastoid foramina are larger in larger and more brachycephalic skulls, which increases the emissary potential flow in the Czech sample and males, when compared with the Italian samples and females, respectively. The number of mastoid foramina increases in wider skulls. This anatomic information is necessary to develop further morphological and functional inferences on the relationships between neurocranial bones and vessels at the genetic, ontogenetic, and phylogenetic levels.
Collapse
Affiliation(s)
- Stanislava Eisová
- Department of Anthropology and Human GeneticsCharles UniversityPragueCzech Republic
- Department of AnthropologyNational MuseumPragueCzech Republic
| | - Hana Píšová
- Department of Anthropology and Human GeneticsCharles UniversityPragueCzech Republic
| | - Petr Velemínský
- Department of AnthropologyNational MuseumPragueCzech Republic
| | - Emiliano Bruner
- Centro Nacional de Investigación sobre la Evolución HumanaBurgosSpain
| |
Collapse
|
64
|
Abstract
The tentorium cerebelli is an integral part of the reciprocal tension membranes that divide some brain areas: the falx cerebri, the falx cerebelli, and the diaphragma sellae. The article is divided into two parts. The first part reviews the anatomy of the tentorium cerebelli, the dura mater, and the ligaments and cervical muscles connected to the tentorium. The tentorial area may be subject to trauma or surgery and knowledge of anatomy and existing relationships is essential to better understand the clinical picture. The second part reviews the systemic relationships of the tentorium cerebelli. The neurological anatomical information, which links the tentorium to the central and peripheral nervous systems, venous brain drainage. The tentorium is not just a body segment, but a systemic communication tool.
Collapse
Affiliation(s)
- Bruno Bordoni
- Cardiology, Foundation Don Carlo Gnocchi, Milan, ITA
| | | | | |
Collapse
|
65
|
Meningeal Melanocytoma Associated with Nevus of Ota: Analysis of Twelve Reported Cases. World Neurosurg 2019; 127:e311-e320. [PMID: 30904806 DOI: 10.1016/j.wneu.2019.03.113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/09/2019] [Accepted: 03/11/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Primary melanocytic neoplasms (PMNs) are rare neoplasms, especially within the central nervous system. Meningeal melanocytomas, a subtype of PMN, are even rarer. Nevus of Ota results from the incomplete migration of melanocytes from the neural crest. Synchronous nevus of Ota and meningeal melanocytoma are infrequently encountered in clinical practice. OBJECTIVE To evaluate and elucidate 12 cases of synchronous meningeal melanocytoma and nevus of Ota, thereby improving the understanding of the relationship between these 2 diseases. METHODS We reviewed cases and searched the English-language literature from the PubMed database and collected clinical parameters of 12 cases of synchronously occurring nevus of Ota and meningeal melanocytoma. RESULTS Among the 12 cases, 90.90% and 91.66% of the lesions were located ipsilaterally and supratentorially, respectively. CONCLUSIONS Our findings indicated a trend for both types of lesion to be located ipsilaterally and supratentorially. When a patient with nevus of Ota is found to harbor an intracranial neoplasm, the most likely diagnosis is PMN.
Collapse
|
66
|
Dasgupta K, Jeong J. Developmental biology of the meninges. Genesis 2019; 57:e23288. [PMID: 30801905 DOI: 10.1002/dvg.23288] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 01/14/2023]
Abstract
The meninges are membranous layers surrounding the central nervous system. In the head, the meninges lie between the brain and the skull, and interact closely with both during development. The cranial meninges originate from a mesenchymal sheath on the surface of the developing brain, called primary meninx, and undergo differentiation into three layers with distinct histological characteristics: the dura mater, the arachnoid mater, and the pia mater. While genetic regulation of meningeal development is still poorly understood, mouse mutants and other models with meningeal defects have demonstrated the importance of the meninges to normal development of the calvaria and the brain. For the calvaria, the interactions with the meninges are necessary for the progression of calvarial osteogenesis during early development. In later stages, the meninges control the patterning of the skull and the fate of the sutures. For the brain, the meninges regulate diverse processes including cell survival, cell migration, generation of neurons from progenitors, and vascularization. Also, the meninges serve as a stem cell niche for the brain in the postnatal life. Given these important roles of the meninges, further investigation into the molecular mechanisms underlying meningeal development can provide novel insights into the coordinated development of the head.
Collapse
Affiliation(s)
- Krishnakali Dasgupta
- New York University College of Dentistry, Department of Basic Science and Craniofacial Biology, New York, New York
| | - Juhee Jeong
- New York University College of Dentistry, Department of Basic Science and Craniofacial Biology, New York, New York
| |
Collapse
|
67
|
Tanaka M. Embryological Consideration of Dural AVFs in Relation to the Neural Crest and the Mesoderm. Neurointervention 2019; 14:9-16. [PMID: 30827062 PMCID: PMC6433192 DOI: 10.5469/neuroint.2018.01095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 01/29/2019] [Accepted: 02/15/2019] [Indexed: 01/08/2023] Open
Abstract
Intracranial and spinal dural arteriovenous fistulas (DAVFs) are vascular pathologies of the dural membrane with arteriovenous shunts. They are abnormal communications between arteries and veins or dural venous sinuses that sit between the two sheets of the dura mater. The dura propria faces the surface of brain, and the osteal dura faces the bone. The location of the shunt points is not distributed homogeneously on the surface of the dural membrane, but there are certain areas susceptible to DAVFs. The dura mater of the olfactory groove, falx cerebri, inferior sagittal sinus, tentorium cerebelli, and falx cerebelli, and the dura mater at the level of the spinal cord are composed only of dura propria, and these areas are derived from neural crest cells. The dura mater of the cavernous sinus, transverse sinus, sigmoid sinus, and anterior condylar confluence surrounding the hypoglossal canal are composed of both dura propria and osteal dura; this group is derived from mesoderm. Although the cause of this heterogeneity has not yet been determined, there are some specific characteristics and tendencies in terms of the embryological features. The possible reasons for the segmental susceptibility to DAVFs are summarized based on the embryology of the dura mater.
Collapse
Affiliation(s)
- Michihiro Tanaka
- Department of Neurosurgery, Kameda Medical Center, Kamogawa, Japan
| |
Collapse
|
68
|
Nicholson P, Hilditch C, Brinjikji W, Krings T. Asystole during onyx embolisation of a dural AV fistula: The trigeminocardiac reflex. Interv Neuroradiol 2018; 25:132-134. [PMID: 30227807 DOI: 10.1177/1591019918800801] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There are fewer than 20 published case reports of bradycardia or asystole during intracranial embolisation procedures. These are well described in open neurosurgical procedures, particularly involving the skull base. We present a case of a 59-year-old male patient who presented for elective embolisation of a dural arteriovenous fistula. During the injection of Onyx, the patient experience sudden asystole, which recurred after a second Onyx injection. Following successful treatment, a third injection proceeded without incident.
Collapse
Affiliation(s)
- Patrick Nicholson
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Canada
| | - Christopher Hilditch
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Canada
| | - Waleed Brinjikji
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Canada
| | - Timo Krings
- Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Canada
| |
Collapse
|
69
|
Abstract
PURPOSE To review the recent data about orbital development and sort out the controversies from the very early stages during embryonic life till final maturation of the orbit late in fetal life, and to appreciate the morphogenesis of all the definitive structures in the orbit in a methodical and timely fashion. METHODS The authors extensively review major studies detailing every aspect of human embryologic and fetal orbital morphogenesis including the development of extraocular muscles, orbital fat, vessels, nerves, and the supportive connective tissue framework as well as bone. These interdisciplinary studies span almost a century and a half, and include some significant controversial opposing points of view which the authors hopefully sort out. The authors also highlight a few of the most noteworthy molecular biologic studies regarding the multiple and interacting signaling pathways involved in regulating normal orbital morphogenesis. RESULTS Orbital morphogenesis involves a successive series of subtle yet tightly regulated morphogenetic events that could only be explained through the chronological narrative used by the authors. The processes that trigger and contribute to the formation of the orbits are complex and seem to be intricately regulated by multifaceted interactions and bidirectional cross-talk between a multitude of cellular building raw materials including the developing optic vesicles, neuroectoderm, cranial neural crest cells and mesoderm. CONCLUSIONS Development of the orbit is a collective enterprise necessitating interactions between, as well as contributions from different cell populations both within and beyond the realm of the orbit. A basic understanding of the processes underlying orbital ontogenesis is a crucial first step toward establishing a genetic basis or an embryologic link with orbital disease.
Collapse
|
70
|
Herisson F, Frodermann V, Courties G, Rohde D, Sun Y, Vandoorne K, Wojtkiewicz GR, Masson GS, Vinegoni C, Kim J, Kim DE, Weissleder R, Swirski FK, Moskowitz MA, Nahrendorf M. Direct vascular channels connect skull bone marrow and the brain surface enabling myeloid cell migration. Nat Neurosci 2018; 21:1209-1217. [PMID: 30150661 PMCID: PMC6148759 DOI: 10.1038/s41593-018-0213-2] [Citation(s) in RCA: 289] [Impact Index Per Article: 48.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/23/2018] [Indexed: 01/05/2023]
Abstract
Innate immune cells recruited to inflammatory sites have short life spans and originate from the marrow, which is distributed throughout the long and flat bones. While bone marrow production and release of leukocyte increases after stroke, it is currently unknown whether its activity rises homogeneously throughout the entire hematopoietic system. To address this question, we employed spectrally resolved in vivo cell labeling in the murine skull and tibia. We show that in murine models of stroke and aseptic meningitis, skull bone marrow-derived neutrophils are more likely to migrate to the adjacent brain tissue than cells that reside in the tibia. Confocal microscopy of the skull-dura interface revealed myeloid cell migration through microscopic vascular channels crossing the inner skull cortex. These observations point to a direct local interaction between the brain and the skull bone marrow through the meninges.
Collapse
Affiliation(s)
- Fanny Herisson
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Vanessa Frodermann
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Gabriel Courties
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David Rohde
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Yuan Sun
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Katrien Vandoorne
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Gregory R Wojtkiewicz
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Gustavo Santos Masson
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Claudio Vinegoni
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jiwon Kim
- Molecular Imaging and Neurovascular Research Laboratory, Department of Neurology, Dongguk University College of Medicine, Goyang, South Korea
| | - Dong-Eog Kim
- Molecular Imaging and Neurovascular Research Laboratory, Department of Neurology, Dongguk University College of Medicine, Goyang, South Korea
| | - Ralph Weissleder
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Systems Biology, Harvard Medical School, Boston, MA, USA
| | - Filip K Swirski
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael A Moskowitz
- Stroke and Neurovascular Regulation Laboratory, Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Matthias Nahrendorf
- Center for Systems Biology, Department of Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
71
|
Chen Z, Chen S, Liu J. The role of T cells in the pathogenesis of Parkinson's disease. Prog Neurobiol 2018; 169:1-23. [PMID: 30114440 DOI: 10.1016/j.pneurobio.2018.08.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/24/2018] [Accepted: 08/12/2018] [Indexed: 02/06/2023]
Abstract
Recent evidence has shown that neuroinflammation plays a key role in the pathogenesis of Parkinson's disease (PD). However, different components of the brain's immune system may exert diverse effects on neuroinflammatory events in PD. The adaptive immune response, especially the T cell response, can trigger type 1 pro-inflammatory activities and suppress type 2 anti-inflammatory activities, eventually resulting in deregulated neuroinflammation and subsequent dopaminergic neurodegeneration. Additionally, studies have increasingly shown that therapies targeting T cells can alleviate neurodegeneration and motor behavior impairment in animal models of PD. Therefore, we conclude that abnormal T cell-mediated immunity is a fundamental pathological process that may be a promising translational therapeutic target for Parkinson's disease.
Collapse
Affiliation(s)
- Zhichun Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated with the Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Shengdi Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated with the Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jun Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated with the Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| |
Collapse
|
72
|
Rai R, Iwanaga J, Shokouhi G, Oskouian RJ, Tubbs RS. The Tentorium Cerebelli: A Comprehensive Review Including Its Anatomy, Embryology, and Surgical Techniques. Cureus 2018; 10:e3079. [PMID: 30305987 PMCID: PMC6168052 DOI: 10.7759/cureus.3079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The tentorium cerebelli functions as a partition, dispelling the burden of weight from supratentorial structures upon inferior brain matter. Clinicians and neurosurgeons, when assessing pathological findings, should have knowledge regarding the tentorium cerebelli anatomy. This work of literature is a comprehensive review of the tentorium cerebelli, including its anatomy, embryology, and clinical and surgical implications. The evolutionary pattern demonstrates sequential stages to higher mammalian lineage. An understanding of the complexity of the neurovascular structures and the anatomy of the tentorium cerebelli is crucial for surgical procedures by neurosurgeons.
Collapse
Affiliation(s)
- Rabjot Rai
- Anatomy, St. George's University School of Medicine, St. George's, GRD
| | - Joe Iwanaga
- Medical Education and Simulation, Seattle Science Foundation, Seattle, USA
| | | | - Rod J Oskouian
- Neurosurgery, Swedish Neuroscience Institute, Seattle, USA
| | - R Shane Tubbs
- Neurosurgery, Seattle Science Foundation, Seattle, USA
| |
Collapse
|
73
|
Bordoni B, Morabito B. Symptomatology Correlations Between the Diaphragm and Irritable Bowel Syndrome. Cureus 2018; 10:e3036. [PMID: 30258735 PMCID: PMC6153095 DOI: 10.7759/cureus.3036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/23/2018] [Indexed: 12/13/2022] Open
Abstract
Irritable bowel syndrome (IBS) is one of the most debilitating and common gastrointestinal disorders; nevertheless, its pathophysiology is still unclear. It affects 11% of the world's population, and is characterized by alternating periods of pain and/or motility disorders with periods of remission and without any evidence of any structural and functional organic variation. It has been recently proposed that an altered contractile ability of the diaphragm muscle might adversely influence intestinal motility. The text reviews the diaphragm's functions, anatomy, and neurological links in correlation with the presence of chronic symptoms associated to IBS, like chronic low back pain, chronic pelvic pain, chronic headache, and temporomandibular joint dysfunction, vagus nerve inflammation, and depression and anxiety. The interplay between an individual's breath dynamic and intestinal behaviour is still an unaddressed point in the physiopathology of IBS, and the paucity of scientific studies should recommend further research to better understand the importance of breathing in this syndrome.
Collapse
Affiliation(s)
- Bruno Bordoni
- Cardiology, Foundation Don Carlo Gnocchi (IRCCS)/Institute of Hospitalization and Care, Milano, ITA
| | - Bruno Morabito
- Osteopathy, School of Osteopathic Centre for Research and Studies, Rome, ITA
| |
Collapse
|
74
|
Abstract
Craniosynostosis is one of the most common craniofacial conditions treated by neurologic and plastic surgeons. In addition to disfigurement, children with craniosynostosis experience significant cognitive dysfunction later in life. Surgery is performed in infancy to correct skull deformity; however, the field is at a crossroads regarding the best approach for correction. Since the cause of brain dysfunction in these patients has remained uncertain, the role and type of surgery might have in attenuating the later-observed cognitive deficits through impact on the brain has been unclear. Recently, however, advances in imaging such as event-related potentials, diffusion tensor imaging, and functional MRI, in conjunction with more robust clinical studies, are providing important insight into the potential etiologies of brain dysfunction in syndromic and nonsyndromic craniosynostosis patients. This review aims to outline the cause(s) of such brain dysfunction including the role extrinsic vault constriction might have on brain development and the current evidence for an intrinsic modular developmental error in brain development. Illuminating the cause of brain dysfunction will identify the role of surgery can play in improving observed functional deficits and thus direct optimal primary and adjuvant treatment.
Collapse
|
75
|
Benakis C, Llovera G, Liesz A. The meningeal and choroidal infiltration routes for leukocytes in stroke. Ther Adv Neurol Disord 2018; 11:1756286418783708. [PMID: 29977343 PMCID: PMC6024265 DOI: 10.1177/1756286418783708] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 05/11/2018] [Indexed: 12/26/2022] Open
Abstract
Stroke is a major health burden as it is a leading cause of morbidity and mortality worldwide. Blood flow restoration, through thrombolysis or endovascular thrombectomy, is the only effective treatment but is restricted to a limited proportion of patients due to time window constraint and accessibility to technology. Over the past two decades, research has investigated the basic mechanisms that lead to neuronal death following cerebral ischemia. However, the use of neuroprotective paradigms in stroke has been marked by failure in translation from experimental research to clinical practice. In the past few years, much attention has focused on the immune response to acute cerebral ischemia as a major factor to the development of brain lesions and neurological deficits. Key inflammatory processes after stroke include the activation of resident glial cells as well as the invasion of circulating leukocytes. Recent research on anti-inflammatory strategies for stroke has focused on limiting the transendothelial migration of peripheral immune cells from the compromised vasculature into the brain parenchyma. However, recent trials testing the blockage of cerebral leukocyte infiltration in patients reported inconsistent results. This emphasizes the need to better scrutinize how immune cells are regulated at the blood-brain interface and enter the brain parenchyma, and particularly to also consider alternative cerebral infiltration routes for leukocytes, including the meninges and the choroid plexus. Understanding how immune cells migrate to the brain via these alternative pathways has the potential to develop more effective approaches for anti-inflammatory stroke therapies.
Collapse
Affiliation(s)
- Corinne Benakis
- Institute for Stroke and Dementia Research, University Medical Center Munich, Feodor-Lynen-Str. 17, Munich 81377, Germany
| | - Gemma Llovera
- Institute for Stroke and Dementia Research, University Medical Center Munich, Munich, Germany
| | - Arthur Liesz
- Institute for Stroke and Dementia Research, University Medical Center Munich, Munich, Germany Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| |
Collapse
|
76
|
De Kegel D, Vastmans J, Fehervary H, Depreitere B, Vander Sloten J, Famaey N. Biomechanical characterization of human dura mater. J Mech Behav Biomed Mater 2018; 79:122-134. [DOI: 10.1016/j.jmbbm.2017.12.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/08/2017] [Accepted: 12/22/2017] [Indexed: 11/24/2022]
|
77
|
Tanaka M. Falcotentorial Location of Dural Arteriovenous Fistulas Derived from the Neural Crest as a Risk Factor for Aggressive Clinical Course. ACTA NEUROCHIRURGICA SUPPLEMENT 2018; 129:121-126. [DOI: 10.1007/978-3-319-73739-3_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
78
|
Glaister J, Carass A, Pham DL, Butman JA, Prince JL. Falx Cerebri Segmentation via Multi-atlas Boundary Fusion. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2017; 10433:92-99. [PMID: 28944346 DOI: 10.1007/978-3-319-66182-7_11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The falx cerebri is a meningeal projection of dura in the brain, separating the cerebral hemispheres. It has stiffer mechanical properties than surrounding tissue and must be accurately segmented for building computational models of traumatic brain injury. In this work, we propose a method to segment the falx using T1-weighted magnetic resonance images (MRI) and susceptibility-weighted MRI (SWI). Multi-atlas whole brain segmentation is performed using the T1-weighted MRI and the gray matter cerebrum labels are extended into the longitudinal fissure using fast marching to find an initial estimate of the falx. To correct the falx boundaries, we register and then deform a set of SWI with manually delineated falx boundaries into the subject space. The continuous-STAPLE algorithm fuses sets of corresponding points to produce an estimate of the corrected falx boundary. Correspondence between points on the deformed falx boundaries is obtained using coherent point drift. We compare our method to manual ground truth, a multi-atlas approach without correction, and single-atlas approaches.
Collapse
Affiliation(s)
- Jeffrey Glaister
- Dept. of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Aaron Carass
- Dept. of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.,Dept. of Computer Science, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Dzung L Pham
- CNRM, Henry Jackson Foundation, Bethesda, MD 20817, USA
| | - John A Butman
- Radiology and Imaging Sciences, NIH, Bethesda, MD 20892, USA
| | - Jerry L Prince
- Dept. of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.,Dept. of Computer Science, Johns Hopkins University, Baltimore, MD 21218, USA
| |
Collapse
|
79
|
The rising root sign: the magnetic resonance appearances of post-operative spinal subdural extra-arachnoid collections. Skeletal Radiol 2017; 46:1225-1231. [PMID: 28578526 DOI: 10.1007/s00256-017-2682-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 02/02/2023]
Abstract
We present a case series of symptomatic post-operative spinal subdural extra-arachnoid collections that displace the cauda equina roots anteriorly. This is described as the "rising root sign".
Collapse
|
80
|
Cheshire EC, Malcomson RDG, Joseph S, Adnan A, Adlam D, Rutty GN. Post-mortem imaging of the infant and perinatal dura mater and superior sagittal sinus using optical coherence tomography. Int J Legal Med 2017; 131:1377-1383. [PMID: 28389927 PMCID: PMC5556134 DOI: 10.1007/s00414-017-1570-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 03/06/2017] [Indexed: 10/25/2022]
Abstract
Infants and young children are likely to present with subdural haemorrhage (SDH) if they are the victims of abusive head trauma. In these cases, the most accepted theory for the source of bleeding is the bridging veins traversing from the surface of the brain to the dura mater. However, some have suggested that SDH may result from leakage of blood from a dural vascular plexus. As post-mortem examination of the bridging veins and dura is challenging, and imaging modalities such as magnetic resonance and computed tomography do not have the resolution capabilities to image small blood vessels, we have trialled the use of intravascular and benchtop optical coherence tomography (OCT) systems for imaging from within the superior sagittal sinus (SSS) and through the dura during five infant/perinatal autopsies. Numerous vessel-like structures were identified using both OCT systems. Measurements taken with the intravascular rotational system indicate that the approximate median diameters of blood vessels entering anterior and posterior segments of the SSS were 110 μm (range 70 to 670 μm, n = 21) and 125 μm (range 70 to 740 μm, n = 23), respectively. For blood vessels close to the wall of the SSS, the median diameters for anterior and posterior segments of the SSS were 80 μm (range 40 to 170 μm, n = 25) and 90 μm (range 30 to 150 μm), respectively. Detailed characterisation of the dural vasculature is important to aid understanding of the source of SDH. High resolution 3-dimensional reconstructions of the infant dural vasculature may be possible with further development of OCT systems.
Collapse
Affiliation(s)
- Emma C Cheshire
- East Midlands Forensic Pathology Unit, University of Leicester, Robert Kilpatrick Building, Level 3 Leicester Royal Infirmary, Leicester, LE2 7LX, UK.
| | - Roger D G Malcomson
- Histopathology Department, Leicester Royal Infirmary, Infirmary Close, Leicester, LE1 5WW, UK
| | - Shiju Joseph
- Department of Cardiovascular Sciences, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK
| | - Asif Adnan
- Department of Cardiovascular Sciences, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK
| | - David Adlam
- Department of Cardiovascular Sciences, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK
| | - Guy N Rutty
- East Midlands Forensic Pathology Unit, University of Leicester, Robert Kilpatrick Building, Level 3 Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| |
Collapse
|
81
|
Yoshioka S, Satomi J, Nagahiro S. In Reply: Transarterial N-Butyl-2-cyanoacrylate Embolization of anIntraosseous Dural Arteriovenous FistulaAssociated With Acute Epidural Hematoma:Technical Case Report. Oper Neurosurg (Hagerstown) 2017; 13:E2-E3. [PMID: 28927225 DOI: 10.1093/ons/opx003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 09/23/2016] [Indexed: 11/13/2022] Open
|
82
|
Torcular pseudomass: a potential diagnostic pitfall in infants and young children. Pediatr Radiol 2017; 47:227-234. [PMID: 27826677 DOI: 10.1007/s00247-016-3734-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/24/2016] [Accepted: 10/13/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Incidental findings on brain MRI may constitute a diagnostic pitfall. We observed an incidental extra-axial midline rounded pseudomass between the torcular Herophili and the occipital squama, with spontaneous resolution, which we called "torcular pseudomass." OBJECTIVE We investigated the frequency, imaging features, natural history and developmental background of this finding in a large group of infants and young children. MATERIALS AND METHODS We conducted a single-center retrospective study by reviewing all brain MRIs performed in children younger than 3 years between 2007 and 2013 in a specialized pediatric hospital. We looked for soft tissue (minimum 2 mm thick) interposed between the torcula and the occipital squama on midsagittal T1 and T2 images; we recorded the maximal diameters and outcome. RESULTS Of 2,283 the children who had brain MRIs during the study period, 291 (12.7%, 95% confidence interval [CI] 0.11, 0.14) presented with a torcular pseudomass (median age 4 months, range 0 days to 35 months, 56% male). MRI features were the same in all of these children: T1 isointensity and T2 hyperintensity to the cerebral cortex, facilitated diffusion on diffusion-weighted imaging and apparent diffusion coefficient maps, and contrast enhancement. The median diameters were: anteroposterior, 5.8 mm; transverse, 10.5 mm; cranio-caudal, 20.6 mm. Follow-up MRI was available in 34.7% (95% CI: 0.20, 0.40) of the children; median follow-up time was 18 months. Among these children, 35.6% (95% CI: 0.26, 0.45) had total involution, 52.5% (95% CI: 0.26, 0.62) had partial involution and 4.1% (95% CI: 0.05, 0.18) showed stability. CONCLUSION Redundant soft tissue in the torcular region, or torcular pseudomass, is not an infrequent finding in infants and young children. It should be considered a physiological tissue, reflecting the postnatal developmental process of the brain and cranial vault, without the need for further investigation or follow-up imaging studies.
Collapse
|
83
|
TANAKA M. Embryological Consideration of Dural Arteriovenous Fistulas. Neurol Med Chir (Tokyo) 2016; 56:544-51. [PMID: 27250699 PMCID: PMC5027237 DOI: 10.2176/nmc.oa.2015-0313] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/25/2016] [Indexed: 01/09/2023] Open
Abstract
The topographical distribution of dural arteriovenous fistulas (DAVFs) was analyzed based on the embryological anatomy of the dural membrane. Sixty-six consecutive cases of intracranial and spinal DAVFs were analyzed based on the angiography, and each shunt point was identified according to the embryological bony structures. The area of dural membranes was categorized into three different groups: a ventral group located on the endochondral bone (VE group), a dorsal group located on the membranous bone (DM group) and a falco-tentorial group (FT group) located in the falx cerebri, tentorium cerebelli, falx cerebelli, and diaphragm sellae. The FT group was designated when the dural membrane was formed only with the dura propria (meningeal layer of the dura mater) and not from the endosteal dura. Cavernous sinus, sigmoid sinus, and anterior condylar confluence was categorized to VE group, which had a female predominance, more benign clinical presentations, and a lower rate of cortical and spinal venous reflux. Transverse sinus, confluence, and superior sagittal sinus belonged to the DM group. Olfactory groove, falx, tent of the cerebellum, and nerve sleeve of spinal cord were categorized to the FT group, which presented later in life and which had a male predominance, more aggressive clinical presentations, and significant cortical and spinal venous reflux. The DAVFs was associated with the layers of the dural membrane characterized by the two different embryological bony structures. The FT group was formed only with the dura propria as an independent risk factor for aggressive clinical course and hemorrhage of DAVFs.
Collapse
Affiliation(s)
- Michihiro TANAKA
- Department of Neurosurgery, Kameda Medical Center, Kamogawa City, Chiba, Japan
| |
Collapse
|
84
|
Yalcin A, Ceylan M, Bayraktutan OF, Sonkaya AR, Yuce I. Age and gender related prevalence of intracranial calcifications in CT imaging; data from 12,000 healthy subjects. J Chem Neuroanat 2016; 78:20-24. [PMID: 27475519 DOI: 10.1016/j.jchemneu.2016.07.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/20/2016] [Accepted: 07/20/2016] [Indexed: 01/15/2023]
Abstract
PURPOSE Location and extent of intracranial calcifications have been detected accurately with the use of CT technology and since, many clinical or pathological entities have been linked to these calcifications. Our purpose is to provide data regarding the prevalence of calcifications in various locations in brain. MATERIAL AND METHODS We retrospectively examined 11,941 subjects who underwent non-contrast enhanced brain CT examination. We determined the prevalence of choroid plexus, pineal gland, habenula, dura mater, basal ganglia and vascular calcifications. RESULTS Of 11,941 subjects, 70.2% had choroid plexus calcifications. Calcifications were most frequently seen in pineal gland and 71.6% of the study population had pineal calcifications. Habeluna and dural calcifications were present in 19.2% and 12.5% of the population respectively. Basal ganglia calcifications and vascular calcifications only constituted 1.3% and 3.5% of the study population respectively. Male dominance was present in all calcification types except basal ganglia calcifications. CONCLUSIONS Showing associations and dissociations from the literature, our study provides a baseline data regarding the prevalence of various types of intracranial calcifications.
Collapse
Affiliation(s)
- Ahmet Yalcin
- Section of Radiology, Regional Education and Research Hospital, Erzurum, Turkey.
| | - Mustafa Ceylan
- Section of Neurology, Regional Education and Research Hospital, Erzurum, Turkey
| | | | - Ali Rıza Sonkaya
- Section of Neurology, Mareşal Çakmak Military Hospital, Erzurum, Turkey
| | - Ihsan Yuce
- Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
85
|
Degenhart AD, Eles J, Dum R, Mischel JL, Smalianchuk I, Endler B, Ashmore RC, Tyler-Kabara EC, Hatsopoulos NG, Wang W, Batista AP, Cui XT. Histological evaluation of a chronically-implanted electrocorticographic electrode grid in a non-human primate. J Neural Eng 2016; 13:046019. [PMID: 27351722 DOI: 10.1088/1741-2560/13/4/046019] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Electrocorticography (ECoG), used as a neural recording modality for brain-machine interfaces (BMIs), potentially allows for field potentials to be recorded from the surface of the cerebral cortex for long durations without suffering the host-tissue reaction to the extent that it is common with intracortical microelectrodes. Though the stability of signals obtained from chronically implanted ECoG electrodes has begun receiving attention, to date little work has characterized the effects of long-term implantation of ECoG electrodes on underlying cortical tissue. APPROACH We implanted and recorded from a high-density ECoG electrode grid subdurally over cortical motor areas of a Rhesus macaque for 666 d. MAIN RESULTS Histological analysis revealed minimal damage to the cortex underneath the implant, though the grid itself was encapsulated in collagenous tissue. We observed macrophages and foreign body giant cells at the tissue-array interface, indicative of a stereotypical foreign body response. Despite this encapsulation, cortical modulation during reaching movements was observed more than 18 months post-implantation. SIGNIFICANCE These results suggest that ECoG may provide a means by which stable chronic cortical recordings can be obtained with comparatively little tissue damage, facilitating the development of clinically viable BMI systems.
Collapse
Affiliation(s)
- Alan D Degenhart
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA. Center for the Neural Basis of Cognition, Pittsburgh, PA, USA. Systems Neuroscience Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
86
|
Jin SW, Sim KB, Kim SD. Development and Growth of the Normal Cranial Vault : An Embryologic Review. J Korean Neurosurg Soc 2016; 59:192-6. [PMID: 27226848 PMCID: PMC4877539 DOI: 10.3340/jkns.2016.59.3.192] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/25/2016] [Accepted: 03/28/2016] [Indexed: 11/27/2022] Open
Abstract
Understanding the development of a skull deformity requires an understanding of the normal morphogenesis of the cranium. Craniosynostosis is the premature, pathologic ossification of one or more cranial sutures leading to skull deformities. A review of the English medical literature using textbooks and standard search engines was performed to gather information about the prenatal development and growth of the cranial vault of the neurocranium. A process of morphogenic sequencing begins during prenatal development and growth, continues postnatally, and contributes to the basis for the differential manner of growth of cranial vault bones. This improved knowledge might facilitate comprehension of the pathophysiology of craniosynostosis.
Collapse
Affiliation(s)
- Sung-Won Jin
- Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ki-Bum Sim
- Department of Neurosurgery, Jeju National University Hospital, Jeju, Korea
| | - Sang-Dae Kim
- Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| |
Collapse
|
87
|
Rangel de Lázaro G, de la Cuétara JM, Píšová H, Lorenzo C, Bruner E. Diploic vessels and computed tomography: Segmentation and comparison in modern humans and fossil hominids. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 159:313-24. [DOI: 10.1002/ajpa.22878] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/10/2015] [Accepted: 09/21/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Gizéh Rangel de Lázaro
- Área de Prehistoria; Universitat Rovira I Virgili; Tarragona Spain
- Institut Català De Paleoecologia Humana I Evolució Social (IPHES); Tarragona Spain
| | | | - Hana Píšová
- Antropologické Oddělení; Univerzita Karlova and Národní Muzeum; Prague Czech Republic
| | - Carlos Lorenzo
- Área de Prehistoria; Universitat Rovira I Virgili; Tarragona Spain
- Institut Català De Paleoecologia Humana I Evolució Social (IPHES); Tarragona Spain
| | - Emiliano Bruner
- Grupo de Paleobiología; Centro Nacional De Investigación Sobre La Evolución Humana (CENIEH); Burgos Spain
| |
Collapse
|
88
|
Bifari F, Berton V, Pino A, Kusalo M, Malpeli G, Di Chio M, Bersan E, Amato E, Scarpa A, Krampera M, Fumagalli G, Decimo I. Meninges harbor cells expressing neural precursor markers during development and adulthood. Front Cell Neurosci 2015; 9:383. [PMID: 26483637 PMCID: PMC4591429 DOI: 10.3389/fncel.2015.00383] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 09/14/2015] [Indexed: 01/01/2023] Open
Abstract
Brain and skull developments are tightly synchronized, allowing the cranial bones to dynamically adapt to the brain shape. At the brain-skull interface, meninges produce the trophic signals necessary for normal corticogenesis and bone development. Meninges harbor different cell populations, including cells forming the endosteum of the cranial vault. Recently, we and other groups have described the presence in meninges of a cell population endowed with neural differentiation potential in vitro and, after transplantation, in vivo. However, whether meninges may be a niche for neural progenitor cells during embryonic development and in adulthood remains to be determined. In this work we provide the first description of the distribution of neural precursor markers in rat meninges during development up to adulthood. We conclude that meninges share common properties with the classical neural stem cell niche, as they: (i) are a highly proliferating tissue; (ii) host cells expressing neural precursor markers such as nestin, vimentin, Sox2 and doublecortin; and (iii) are enriched in extracellular matrix components (e.g., fractones) known to bind and concentrate growth factors. This study underlines the importance of meninges as a potential niche for endogenous precursor cells during development and in adulthood.
Collapse
Affiliation(s)
- Francesco Bifari
- Section of Hematology, Stem Cell Research Laboratory, Department of Medicine, University of Verona Verona, Italy
| | - Valeria Berton
- Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Annachiara Pino
- Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Marijana Kusalo
- Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Giorgio Malpeli
- Section of Pathological Anatomy, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Marzia Di Chio
- Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Emanuela Bersan
- Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Eliana Amato
- Section of Pathological Anatomy, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Aldo Scarpa
- Section of Pathological Anatomy, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Mauro Krampera
- Section of Hematology, Stem Cell Research Laboratory, Department of Medicine, University of Verona Verona, Italy
| | - Guido Fumagalli
- Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| | - Ilaria Decimo
- Section of Pharmacology, Department of Diagnostics and Public Health, University of Verona Verona, Italy
| |
Collapse
|
89
|
Rambaud C. Bridging veins and autopsy findings in abusive head trauma. Pediatr Radiol 2015; 45:1126-31. [PMID: 25698365 DOI: 10.1007/s00247-015-3285-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 01/14/2015] [Indexed: 11/29/2022]
Abstract
Bridging veins are crucial for the venous drainage of the brain. They run as short and straight bridges between the brain surface and the superior sagittal sinus in the subdural compartment. Subdural bleeding is a marker for a traumatic mechanism (i.e., acceleration/deceleration, rotational and shearing forces due to violent shaking) causing rupture of the bridging veins. Demonstration of bridging vein rupture allows the unequivocal diagnosis of a traumatic mechanism and should therefore be a routine part of the postmortem in cases of subdural hemorrhage.
Collapse
Affiliation(s)
- Caroline Rambaud
- Service D'anatomie-Pathologique et Médecine Légale, AP-HP, CHU Raymond Poincaré, 104, boulevard Raymond Poincaré, 92380, Garches, France,
| |
Collapse
|
90
|
Evers S, Verbaan D, Sanchez E, Peerdeman S. 3D Volumetric Measurement of Neurofibromatosis Type 2-Associated Meningiomas: Association Between Tumor Location and Growth Rate. World Neurosurg 2015; 84:1062-9. [PMID: 26087434 DOI: 10.1016/j.wneu.2015.05.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Treatment of meningiomas in neurofibromatosis type II (NF2) patients is challenging because the natural history of these tumors is unclear. More insight in tumor growth and factors predicting growth may contribute to a better clinical management. In this study, growth characteristics of supratentorial NF-related meningiomas were examined and the association between tumor growth rate and location was evaluated. METHODS In all NF2 patients followed up at the VU University Medical Center, who underwent a minimum of 3 consecutive scans, tumor volumes were assessed by using 3D volumetric measurement (Brainlab, Feldkirchen, Germany). Growth patterns were visually analyzed. To assess the association between tumor growth rate and tumor location, the meningiomas were divided in 3 groups on the basis of their location: skull base, convexity, and "other." Univariable and multivariable logistic regression models were built. RESULTS Twenty-one patients (13 females) with a mean (standard deviation) follow-up period of 5.55 (2.48) years and a total of 210 meningiomas were included in the analyses. Tumors followed different growth patterns and did not increase in size simultaneously within 1 patient. Skull base meningiomas had a significantly higher absolute growth rate compared with convexity (β = 0.91, 95% confidence interval [CI] 0.08-1.73) and "other" (β = 1.07, 95% CI 0.27-1.86) and a significantly higher relative growth rate on both linear and geometric growth rate compared with "other" (β = 90.73, 95% CI 5.50-175.95 and β = 18.63, 95% CI 2.94-34.31, respectively) on multivariable logistic regression. CONCLUSION Within a single patient, NF2-related meningiomas follow different growth patterns. Skull base meningiomas grow faster compared with other locations. Yearly magnetic resonance imaging scans and timely treatment of skull base meningiomas should be considered.
Collapse
Affiliation(s)
| | - Dagmar Verbaan
- Neurosurgical Center Amsterdam, The Netherlands; Meningioma Group Amsterdam, The Netherlands
| | - Esther Sanchez
- Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Saskia Peerdeman
- Neurosurgical Center Amsterdam, The Netherlands; Meningioma Group Amsterdam, The Netherlands.
| |
Collapse
|
91
|
Chye CL, Lin KH, Ou CH, Sun CK, Chang IW, Liang CL. Acute spontaneous subdural hematoma caused by skull metastasis of hepatocellular carcinoma: case report. BMC Surg 2015; 15:60. [PMID: 25958386 PMCID: PMC4432998 DOI: 10.1186/s12893-015-0045-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 05/04/2015] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Skull and intracranial metastases from hepatocellular carcinoma (HCC) have seldom been reported. A skull metastasis of HCC with a tumor bleeding resulting in spontaneous subdural hematoma (SDH) is extremely unusual. We report the first case of acute spontaneous SDH in a 69-year-old woman who presented with acute onset of headache, because of tumor bleeding caused by skull metastasis of HCC. CASE PRESENTATION A 69-year-old woman was referred to our hospital because of progressive headache, nausea, and vomiting for 3 days. Brain computed tomography (CT) performed in the emergency department (ED) revealed a left temporal SDH with a slight mass effect and a small left temporal bone erosion. Tri-phasic abdominal CT demonstrated a large right lobe liver tumor compatible with HCC. She experienced progressive deterioration of consciousness in the intensive care unit. Follow-up CT showed an enlargement of the SDH. An emergency craniotomy for hematoma evacuation and removal of skull tumor was performed. She regained consciousness and had no neurological deficits during the postoperative course. Pathological examination of the skull specimen indicated metastasis of a HCC. CONCLUSION Patients with acute SDH without a history of head injury are rarely encountered in the ED. Metastatic carcinoma with bleeding should be included as a differential diagnosis for acute spontaneous SDH. Before an operation for SDH, the possibility of metastatic lesion of the skull should be considered in the surgical planning and the origin of malignancy should be sought.
Collapse
Affiliation(s)
- Cien-Leong Chye
- Department of Neurosurgery, E-Da Hospital, School of Medicine, I-Shou University, 1 E-Da Rd., Yan-Chau Dist, 824, Kaohsiung City, Taiwan
| | - Kuo-Hsuan Lin
- Department of Emergency Medicine, E-Da Hospital, School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chang-Hsien Ou
- Department of Diagnostic Radiology, E-Da Hospital, Kaohsiung, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - I-Wei Chang
- Department of Pathology, E-Da Hospital, Kaohsiung, Taiwan
| | - Cheng-Loong Liang
- Department of Neurosurgery, E-Da Hospital, School of Medicine, I-Shou University, 1 E-Da Rd., Yan-Chau Dist, 824, Kaohsiung City, Taiwan.
| |
Collapse
|
92
|
Fratta P, Polke JM, Newcombe J, Mizielinska S, Lashley T, Poulter M, Beck J, Preza E, Devoy A, Sidle K, Howard R, Malaspina A, Orrell RW, Clarke J, Lu CH, Mok K, Collins T, Shoaii M, Nanji T, Wray S, Adamson G, Pittman A, Renton AE, Traynor BJ, Sweeney MG, Revesz T, Houlden H, Mead S, Isaacs AM, Fisher EMC. Screening a UK amyotrophic lateral sclerosis cohort provides evidence of multiple origins of the C9orf72 expansion. Neurobiol Aging 2015; 36:546.e1-7. [PMID: 25179228 PMCID: PMC4270445 DOI: 10.1016/j.neurobiolaging.2014.07.037] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 07/27/2014] [Indexed: 12/13/2022]
Abstract
An expanded hexanucleotide repeat in the C9orf72 gene is the most common genetic cause of amyotrophic lateral sclerosis and frontotemporal dementia (C9ALS/FTD). Although 0-30 hexanucleotide repeats are present in the general population, expansions >500 repeats are associated with C9ALS/FTD. Large C9ALS/FTD expansions share a common haplotype and whether these expansions derive from a single founder or occur more frequently on a predisposing haplotype is yet to be determined and is relevant to disease pathomechanisms. Furthermore, although cases carrying 50-200 repeats have been described, their role and the pathogenic threshold of the expansions remain to be identified and carry importance for diagnostics and genetic counseling. We present clinical and genetic data from a UK ALS cohort and report the detailed molecular study of an atypical somatically unstable expansion of 90 repeats. Our results across different tissues provide evidence for the pathogenicity of this repeat number by showing they can somatically expand in the central nervous system to the well characterized pathogenic range. Our results support the occurrence of multiple expansion events for C9ALS/FTD.
Collapse
Affiliation(s)
- Pietro Fratta
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, University College London, Queen Square, London, UK.
| | | | - Jia Newcombe
- NeuroResource, Institute of Neurology, University College London, Queen Square, London, UK
| | - Sarah Mizielinska
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK
| | - Tammaryn Lashley
- Queen Square Brain Bank for Neurological Disorders, University College London, Queen Square, London, UK
| | - Mark Poulter
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK; MRC Prion Unit, University College London, Queen Square, London, UK
| | - Jon Beck
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK; MRC Prion Unit, University College London, Queen Square, London, UK
| | - Elisavet Preza
- Department of Molecular Neuroscience, University College London, Queen Square, London, UK
| | - Anny Devoy
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK
| | - Katie Sidle
- Department of Molecular Neuroscience, University College London, Queen Square, London, UK; National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Robin Howard
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Andrea Malaspina
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Centre for Neuroscience & Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Richard W Orrell
- MRC Centre for Neuromuscular Diseases, University College London, Queen Square, London, UK; Department of Molecular Neuroscience, University College London, Queen Square, London, UK; National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Jan Clarke
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Ching-Hua Lu
- Centre for Neuroscience & Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Sobell Department of Motor Neuroscience and Movement Disorders, University College London, Queen Square, London, UK
| | - Kin Mok
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London, Queen Square, London, UK
| | - Toby Collins
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK
| | - Maryam Shoaii
- Department of Molecular Neuroscience, University College London, Queen Square, London, UK
| | - Tina Nanji
- Neurogenetics Unit, Queen Square, London, UK
| | - Selina Wray
- Department of Molecular Neuroscience, University College London, Queen Square, London, UK
| | - Gary Adamson
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK; MRC Prion Unit, University College London, Queen Square, London, UK
| | - Alan Pittman
- Department of Molecular Neuroscience, University College London, Queen Square, London, UK
| | - Alan E Renton
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Bryan J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | | | - Tamas Revesz
- Queen Square Brain Bank for Neurological Disorders, University College London, Queen Square, London, UK
| | - Henry Houlden
- Neurogenetics Unit, Queen Square, London, UK; Department of Molecular Neuroscience, University College London, Queen Square, London, UK
| | - Simon Mead
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK
| | - Adrian M Isaacs
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK
| | - Elizabeth M C Fisher
- Department of Neurodegenerative Disease, University College London, Queen Square, London, UK; MRC Centre for Neuromuscular Diseases, University College London, Queen Square, London, UK.
| |
Collapse
|
93
|
Dziedzic T, Bernstein M. Awake craniotomy for brain tumor: indications, technique and benefits. Expert Rev Neurother 2014; 14:1405-15. [PMID: 25413123 DOI: 10.1586/14737175.2014.979793] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Increasing interest in the quality of life of patients after treatment of brain tumors has led to the exploration of methods that can improve intraoperative assessment of neurological status to avoid neurological deficits. The only method that can provide assessment of all eloquent areas of cerebral cortex and white matter is brain mapping during awake craniotomy. This method helps ensure that the quality of life and the neuro-oncological result of treatment are not compromised. Apart from the medical aspects of awake surgery, its economic issues are also favorable. Here, we review the main aspects of awake brain tumor surgery. Neurosurgical, neuropsychological, neurophysiological and anesthetic issues are briefly discussed.
Collapse
Affiliation(s)
- Tomasz Dziedzic
- Medical University of Warsaw, Neurosurgery, Banacha 1a, Warsaw, 02-097, Poland
| | | |
Collapse
|
94
|
Ferreira LB, Bradaschia-Correa V, Moreira MM, Marques NDM, Arana-Chavez VE. Evaluation of bone repair of critical size defects treated with simvastatin-loaded poly(lactic-co-glycolic acid) microspheres in rat calvaria. J Biomater Appl 2014; 29:965-76. [PMID: 25209881 DOI: 10.1177/0885328214550897] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Statins are hypolipemiant drugs with osteoinductive effect. We evaluated the potential of simvastatin loaded into poly(lactic-co-glycolic acid) (PLGA) microspheres to heal critical size defects in rat calvaria. METHODS PLGA scaffolds (50:50 ratio) were synthesized as pure membranes or as microspheres loaded with 2.5% simvastatin. Critical size defects (5-mm diameter) were created in the parietal bone of 3-month-old male Wistar rats; they were either left filled with blood clot (C group), covered with a PLGA membrane (M group) or with PLGA microspheres loaded with simvastatin (MSI group) or not (MM group), and then covered with the PLGA membrane. The defects were evaluated after 30 or 60 days by light and electron microscopy, immunohistochemistry for osteopontin (OPN), bone sialoprotein (BSP) and osteoadherin (OSAD), and immunocytochemistry for OPN. RESULTS Scanning electron microscopy showed that the calvarial defects treated with MSI were almost completely healed after 60 days, while groups M and C presented less bone formation, whereas the bone matrix formed into the defects of MSI group was more organized and mature. The immunolabeling for OPN and BSP on the matrix in groups C and M showed typical areas of primary bone unlike the MSI that presented weak labeling at the formed area. In the MSI group, there was an intense immunostaining for OSAD in osteoid, as well as in osteocyte cytoplasm. The immunocytochemistry showed intense labeling for OPN with homogeneous distribution in the interfibrillar spaces in all groups after 30 days and after 60 days; however, while C and M groups exhibited similar aspect, the MSI specimens showed weak labeling. The ultrastructural evaluation showed the interaction between the biomaterial and the surrounding tissue where some cells established intimate contact with microspheres. CONCLUSIONS The repair of critical size bone defects was accelerated and enhanced by the implantation of simvastatin-loaded PLGA microspheres.
Collapse
Affiliation(s)
- Lorraine B Ferreira
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vivian Bradaschia-Correa
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mariana M Moreira
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Natasha D M Marques
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Victor E Arana-Chavez
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
95
|
Kohyama S, Kakehi Y, Yamane F, Ooigawa H, Kurita H, Ishihara S. Subdural and intracerebral hemorrhage caused by spontaneous bleeding in the middle meningeal artery after coil embolization of a cerebral aneurysm. J Stroke Cerebrovasc Dis 2014; 23:e433-5. [PMID: 25134456 DOI: 10.1016/j.jstrokecerebrovasdis.2014.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/17/2014] [Accepted: 05/22/2014] [Indexed: 10/24/2022] Open
Abstract
Nontraumatic acute subdural hemorrhage (SDH) with intracerebral hemorrhage (ICH) is rare and is usually caused by severe bleeding from aneurysms or arteriovenous fistulas. We encountered a very rare case of spontaneous bleeding from the middle meningeal artery (MMA), which caused hemorrhage in the temporal lobe and subdural space 2 weeks after coil embolization of an ipsilateral, unruptured internal cerebral artery aneurysm in the cavernous portion. At onset, the distribution of hematoma on a computed tomography scan led us to believe that the treated intracavernous aneurysm could bleed into the intradural space. Emergency craniotomy revealed that the dura of the middle fossa was intact except for the point at the foramen spinosum where the exposed MMA was bleeding. Retrospectively, angiography just before and after embolization of the aneurysm did not show any aberrations in the MMA. Although the MMA usually courses on the outer surface of the dura and is unlikely to rupture without an external force, physicians should be aware that the MMA may bleed spontaneously and cause SDH and ICH.
Collapse
Affiliation(s)
- Shinya Kohyama
- Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan.
| | - Yoshiaki Kakehi
- Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Fumitaka Yamane
- Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Hidetoshi Ooigawa
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Hiroki Kurita
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Shoichiro Ishihara
- Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Japan
| |
Collapse
|
96
|
Lv X, Wu Z, Li Y. Innervation of the cerebral dura mater. Neuroradiol J 2014; 27:293-8. [PMID: 24976196 PMCID: PMC4202893 DOI: 10.15274/nrj-2014-10052] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 04/24/2014] [Indexed: 02/07/2023] Open
Abstract
The trigemino-cardiac reflex during Onyx embolization for dural arteriovenous fistula may be caused by mechanical or chemical stimulus to the terminals of the unencapsulated Ruffini-like receptors stemming from A-axons in the dural connective tissue at sites of dural arteries and sinuses. Slow A (Aδ) and fast A (Aβ) neurons may play a role in the stimulus afferent pathway due to their higher mechanosensitivity and chemosensitivity. These afferent pathway nerves are cholinergic innervations of the dura mater, which also contains vasoactive neuropeptides such as calcitonin gene-related peptide, substance P, and neurokinin A. Stimulation of meningeal sensory fibres can evoke cerebral vasodilation through the peripheral release of neuropeptides, which play a role in headache pathogenesis. These myelinated A-fibers terminate in the deep part (laminae III-V) of the spinal dorsal horn. Its efferent pathway has been defined as the acetylcholinergic vagus nerve. The A11 nucleus, located in the posterior hypothalamus, providing the only known source of descending dopaminergic innervation for the spinal grey matter, can inhibit the neurons in the spinal dorsal horn.
Collapse
Affiliation(s)
- Xianli Lv
- /> Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University; Beijing, China
| | - Zhongxue Wu
- /> Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University; Beijing, China
| | - Youxiang Li
- /> Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University; Beijing, China
| |
Collapse
|
97
|
Okamoto H, Mineta T, Wakamiya T, Tsukamoto H, Katsuta T, Nakagaki H, Matsushima T. Two cases of subfrontal schwannoma, including a rare case located between the endosteal and meningeal layers of the dura. Neurol Med Chir (Tokyo) 2013; 54:681-5. [PMID: 24305023 DOI: 10.2176/nmc.cr2013-0153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Subfrontal schwannomas arising from the olfactory groove are rare and their origin remains uncertain because olfactory bulbs do not possess Schwann cells. We present two cases of subfrontal schwannomas treated with surgical resection. In one case, the tumor was located between the endosteal and meningeal layers of the dura mater. This rare case suggests that subfrontal schwannomas may originate from the fila olfactoria.
Collapse
Affiliation(s)
- Hiroaki Okamoto
- Department of Neurosurgery, Faculty of Medicine, Saga University
| | | | | | | | | | | | | |
Collapse
|
98
|
Abstract
INTRODUCTION The pia mater has received less attention in the literature compared to the dura and arachnoid maters. However, its presence as a direct covering of the nervous system and direct relation to the blood vessels gives it a special importance in neurosurgery. METHOD A comprehensive review of the literature was conducted to study all that we could find relating to the pia mater, including history, macro- and microanatomy, embryology, and a full description of the related structures. CONCLUSION The pia mater has an important anatomic position, rich history, complicated histology and embryology, and a significant contribution to a number of other structures that may stabilize and protect the nervous system.
Collapse
|
99
|
Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. J Multidiscip Healthc 2013; 6:281-91. [PMID: 23940419 PMCID: PMC3731110 DOI: 10.2147/jmdh.s45443] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The article explains the scientific reasons for the diaphragm muscle being an important crossroads for information involving the entire body. The diaphragm muscle extends from the trigeminal system to the pelvic floor, passing from the thoracic diaphragm to the floor of the mouth. Like many structures in the human body, the diaphragm muscle has more than one function, and has links throughout the body, and provides the network necessary for breathing. To assess and treat this muscle effectively, it is necessary to be aware of its anatomic, fascial, and neurologic complexity in the control of breathing. The patient is never a symptom localized, but a system that adapts to a corporeal dysfunction.
Collapse
Affiliation(s)
- Bruno Bordoni
- Rehabilitation Cardiology Institute of Hospitalization and Care with Scientific Address, S Maria Nascente Don Carlo Gnocchi Foundation
| | | |
Collapse
|