The fine structure of cellular layers and connective tissue space at spinal nerve root attachments in the rat

The anatomic basis of leptomeningeal metastasis

Leptomeningeal metastasis (LM), or spread of cancer to the cerebrospinal fluid (CSF)-filled space surrounding the central nervous system, is a fatal complication of cancer. Entry into this space poses an anatomical challenge for cancer cells; movement of cells between the blood and CSF is tightly regulated by the blood-CSF barriers. Anatomical understanding of the leptomeninges provides a roadmap of corridors for cancer entry. This Review describes the anatomy of the leptomeninges and routes of cancer spread to the CSF. Granular understanding of LM by route of entry may inform strategies for novel diagnostic and preventive strategies as well as therapies.

Non-invasive MR imaging of human brain lymphatic networks with connections to cervical lymph nodes

Meningeal lymphatic vessels have been described in animal studies, but limited comparable data is available in human studies. Here we show dural lymphatic structures along the dural venous sinuses in dorsal regions and along cranial nerves in the ventral regions in the human brain. 3D T2-Fluid Attenuated Inversion Recovery magnetic resonance imaging relies on internal signals of protein rich lymphatic fluid rather than contrast media and is used in the present study to visualize the major human dural lymphatic structures. Moreover we detect direct connections between lymphatic fluid channels along the cranial nerves and vascular structures and the cervical lymph nodes. We also identify age-related cervical lymph node atrophy and thickening of lymphatics channels in both dorsal and ventral regions, findings which reflect the reduced lymphatic output of the aged brain.

In vivo magnetic resonance imaging at 11.7 Tesla visualized the effects of neonatal transection of infraorbital nerve upon primary and secondary trigeminal pathways in rats

Using 11.7T ultra high-field T2-weighted MRI, the present study aimed to investigate pathological changes of primary and secondary trigeminal pathways following neonatal transection of infraorbital nerve in rats. The trigeminal pathways consist of spinal trigeminal tract, trigeminal sensory nuclear complex, medial lemniscus, ventromedial portion of external medullary lamina and ventral posterior nucleus of thalamus. By selecting optimum parameters of MRI such as repetition time, echo time, and slice orientation, this study visualized the trigeminal pathways in rats without any contrast agents. Pathological changes due to the nerve transection were found at 8 weeks of age as a marked reduction of the areas of the trigeminal pathways connecting from the injured nerve. In addition, T2-weighted MR images of the trigeminal nerve trunk and the spinal trigeminal tract suggest a communication of CSF through the trigeminal nerve between the inside and outside of the brain stem. These results support the utility of ultra high-field MRI system for noninvasive assessment of effects of trigeminal nerve injury upon the trigeminal pathways.

Peripheral nerve: from the microscopic functional unit of the axon to the biomechanically loaded macroscopic structure

Peripheral nerves are composed of motor and sensory axons, associated ensheathing Schwann cells, and organized layers of connective tissues that are in continuity with the tissues of the central nervous system. Nerve fiber anatomy facilitates conduction of electrical impulses to convey information over a distance, and the length of these polarized cells necessitates regulated axonal transport of organelles and structural proteins for normal cell function. Nerve connective tissues serve a protective function as the limb is subjected to the stresses of myriad limb positions and postures. Thus, the tissues are uniquely arranged to control the local nerve fiber environment and modulate physical stresses. In this brief review, we describe the microscopic anatomy and physiology of peripheral nerve and the biomechanical properties that enable nerve to withstand the physical stresses of everyday life.

AAV8(gfp) preferentially targets large diameter dorsal root ganglion neurones after both intra-dorsal root ganglion and intrathecal injection

Adeno-associated viral vectors (AAV) are increasingly used to deliver therapeutic genes to the central nervous system (CNS) where they promote transgene expression in post mitotic neurones for long periods with little or no toxicity. In adult rat dorsal root ganglia (DRG), we investigated the cellular tropism of AAV8 containing the green fluorescent protein gene (gfp) after either intra-lumbar DRG or intrathecal injection and showed that transduced DRG neurones (DRGN) expressed GFP irrespective of the delivery route, while non-neuronal cells were GFP(-). After intra-DRG delivery of AAV8(gfp), the mean DRGN transduction rate was 11%, while intrathecal delivery transduced a mean of 1.5% DRGN. After intra-DRG injection, 2% of small DRGN (<30 μm in diameter) were GFP(+) compared with 32% of large DRGN (>60 μm in diameter). Axons of transduced DRGN were also GFP(+); no intra-spinal neurones were transduced. A small number of contralateral DRGN were transduced after intra-DRG injection, suggesting that AAV8 may diffuse from injected DRG into the spinal canal. Microglia and astrocytes were highly ramified with increased GFAP(+) immunoreactivity (i.e. activated) in the neuropil around GFP(+) DRG axon projections within the cord after intra-DRG injection. This study showed that after both intra-DRG and intrathecal delivery, strong preferential AAV8 tropism exists for large DRGN unassociated with cell death, but GFP(+) axons projecting in the spinal cord induced local glial activation. These results open up opportunities for targeted delivery of therapeutics such as neurotrophic factors to the injured spinal cord.

Homeostatic regulation of the endoneurial microenvironment during development, aging and in response to trauma, disease and toxic insult

The endoneurial microenvironment, delimited by the endothelium of endoneurial vessels and a multi-layered ensheathing perineurium, is a specialized milieu intérieur within which axons, associated Schwann cells and other resident cells of peripheral nerves function. The endothelium and perineurium restricts as well as regulates exchange of material between the endoneurial microenvironment and the surrounding extracellular space and thus is more appropriately described as a blood-nerve interface (BNI) rather than a blood-nerve barrier (BNB). Input to and output from the endoneurial microenvironment occurs via blood-nerve exchange and convective endoneurial fluid flow driven by a proximo-distal hydrostatic pressure gradient. The independent regulation of the endothelial and perineurial components of the BNI during development, aging and in response to trauma is consistent with homeostatic regulation of the endoneurial microenvironment. Pathophysiological alterations of the endoneurium in experimental allergic neuritis (EAN), and diabetic and lead neuropathy are considered to be perturbations of endoneurial homeostasis. The interactions of Schwann cells, axons, macrophages, and mast cells via cell-cell and cell-matrix signaling regulate the permeability of this interface. A greater knowledge of the dynamic nature of tight junctions and the factors that induce and/or modulate these key elements of the BNI will increase our understanding of peripheral nerve disorders as well as stimulate the development of therapeutic strategies to treat these disorders.

The blood-nerve barrier: structure and functional significance

The blood-nerve barrier (BNB) defines the physiological space within which the axons, Schwann cells, and other associated cells of a peripheral nerve function. The BNB consists of the endoneurial microvessels within the nerve fascicle and the investing perineurium. The restricted permeability of these two barriers protects the endoneurial microenvironment from drastic concentration changes in the vascular and other extracellular spaces. It is postulated that endoneurial homeostatic mechanisms regulate the milieu intérieur of peripheral axons and associated Schwann cells. These mechanisms are discussed in relation to nerve development, Wallerian degeneration and nerve regeneration, and lead neuropathy. Finally, the putative factors responsible for the cellular and molecular control of BNB permeability are discussed. Given the dynamic nature of the regulation of the permeability of the perineurium and endoneurial capillaries, it is suggested that the term blood-nerve interface (BNI) better reflects the functional significance of these structures in the maintenance of homeostasis within the endoneurial microenvironment.

Sheaths of the spinal nerve roots. Permeability and structural characteristics of dorsal and ventral spinal nerve roots of the rat

The present study was carried out to investigate the permeability of normal spinal nerve root sheaths around dorsal and ventral roots in the rat. In vivo studies were performed using Evans blue-albumin and lanthanum chloride as tracers. The Evans blue-albumin complex is macromolecular in size and lanthanum ions are small and easily visible in the electron microscope. Both tracers were injected into the subarachnoid space and 15 min later samples were taken and further processed for detection of tracer. Postmortem studies with lanthanum was also performed. Following fixation by cardiac perfusion with fixative without tracer, lanthanum chloride was added to the fixative and applied directly to exposed spinal cord including the spinal nerve roots. Macroscopical examination showed Evans blue staining of the superficial blood vessels of the spinal cord, but no staining of the parenchyma of either spinal cord or nerve roots. Fluorescence microscopy revealed, in addition to a bright red fluorescence of root sheaths, a faint longitudinally orientated red fluorescence in the endoneurium of the nerve roots, indicating the presence of the dye-albumin complex. In both in vivo and post-mortem lanthanum studies, the tracer was detected between cell layers of the nerve root sheath and in invaginations of the plasma membrane of these cells, as well as inside the nerve root parenchyma. Some of the cells of the sheaths in post-mortem animals were diffusely marked with intracellular tracer. The endo-radicular lanthanum was most often seen superficially, but lanthanum could occasionally be detected deeper in the parenchyma in the post mortem studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Structural properties of spinal nerve roots: biomechanics

The biomechanics of spinal nerve roots obtained from normal and nerve-crushed mice were evaluated. Photographs and longitudinal force measurements were taken as nerve roots were elongated through mechanical failure. Proportional limit stress and strain as well as the apparent modulus were calculated from photographic and force measurements to characterize nerve root strength, elasticity, and stiffness, respectively. Resulting mechanical data were indicative of an extremely weak material. Comparisons of nerve and nerve root mechanical properties revealed major differences. While nerve root elasticity was comparable to nerve, nerve root strength was only 10% that of nerve and root stiffness was only 20% of nerve values. Differences in nerve and root mechanics are attributed to the large discrepancies in relative amounts of connective tissue. Also in sharp contrast with peripheral nerve, unilateral nerve crush produced no significant alterations in root mechanics. Comparisons of nerve and nerve root strengths suggested possible pathways for dissipation of peripherally applied forces through epineurial and dural structures.

Interactions between intraspinal Schwann cells and the cellular constituents normally occurring in the spinal cord: an ultrastructural study in the irradiated rat

Relationships between intraspinal Schwann cells and neuroglia, particularly, astrocytes, were studied following X-irradiation of the spinal cord in 3-day-old rats. Initially, this exposure results in a depletion of the neuroglial population. By 10 days post-irradiation (P-I), gaps occur in the glia limitans, although the overlying basal lamina remains intact. Development of and myelination by intraspinal Schwann cells is well underway by 15 days P-I. These Schwann cell-occupied regions have a paucity of astrocyte processes, a finding which persists throughout the study (60 days P-I), and several types of Schwann cell-neuroglial interfaces are observed, including: (1) astrocyte separation of Schwann cells from oligodendrocyte-myelinated regions; (2) intermingling of Schwann cell-myelinated axons and oligodendrocyte-myelinated axons in the absence of astrocyte processes; and (3) ensheathment of unmyelinated axons by astrocyte processes which separate these axons from the Schwann cells. The gaps in the glia limitans widen as the P-I interval increases. At 45 and 60 days P-I, the basal lamina no longer forms a singular, continuous covering over the spinal cord surface, but follows instead a rather tortuous course over the disrupted glia limitans and the intraspinal Schwann cells. Although the mode of initial occurrence of Schwann cells within the spinal cord is not yet understood, the data indicate that the astrocyte population is involved in that process, as well as in limiting the further development of Schwann cells within the substance of the spinal cord.

Destruction of intracerebrally applied red blood cells in cervical lymph nodes. Experimental investigations

In rabbits, intracerebrally applied erythrocytes can move with the cerebrospinal fluid along connecting pathways between the subarachnoid space and the cervical lymph nodes. This study compares the time dependency for the degradation of intracerebrally injected erythrocytes in the brain as well as in the cervical lymph nodes. Rabbits were killed at various predetermined intervals after the intracerebral erythrocyte injection. Microscopic and histologic examination of the brain and the cervical lymph nodes revealed the following findings: (1) Erythrophages first appeared in the brain 24 h after the injection; siderophages, 4 days after the injection. Siderophages were still demonstrable at the conclusion of the study, i.e. 240 days after the injection. (2) In the cervical lymph nodes erythrophages were first observed 1 h after the injection; siderophages, 9 h after the injection. Only isolated erythrophages and siderophages were found in the lymph nodes 12 days after intracerebral injection of red blood cells. Later on no erythrocytes or siderophages were observed in the lymph nodes. The findings indicate that non-phagocytized red blood cells arriving at the lymph nodes were ingested by local macrophages. The extremely rapid ingestion and digestion of the red blood cells by lymph node macrophages as well as the possible reasons were discussed.

Ependyma and meninges of the spinal cord of the mouse. A light-and electron-microscopic study

In addition to ependymal epithelial cells, numerous tanycytes are found along the entire central canal of the mouse. These tanycytes are arranged in clusters in the cervical, thoracic and lumbar segments of the spinal cord. In the conus medullaris, tanycytes separate and ensheath bundles of myelinated and unmyelinated axons; their processes take part in the formation of the stratum marginale gliae. In the caudal part of the spinal cord, the ventral wall of the central canal is thin and some areas are reduced to a single-cell thickness. In this region, ependymal cells participate directly in the formation of the stratum marginale gliae. The meninges consist of the intima piae, the pia mater, the arachnoid, a subdural neurothelium and the dura mater. The subarachnoid space appears occluded and opens only around the spinal roots. In the vicinity of the spinal ganglia, the dura mater, the subdural neurothelium and the arachnoid form a cellular reticulum.

Scanning electron microscopy of the subarachnoid space in the dog: evidence for a non-hematogenous origin of subarachnoid macrophages

Injection of viable BCG into the subarachnoid space of immunized and non-immunized dogs produced a 10-fold increase in the populations of pial free cells. In immunized animals injected three days previously with BCG, stereoscopic SEM revealed that many pial cells had rounded up and were protruding into the subarachnoid space. With continued rounding these cells took on amoeboid characteristics, with shapes that suggested a capacity for cell movement. Internally, these pial cells possessed an increased volume of perinuclear cytoplasm and organelles. Reactive pial cells could be distinguished from macrophages of presumed hematogenous origin on the basis of their surface morphology. These findings suggested that pial cells had the ability to alter their normal structural and behavioral characteristics and to become macrophage-like under these conditions of secondary challenge by BCG.

Lymphatic efflux of intracerebrally injected cells

Following intracerebral injection of labeled erythrocytes, lymphocytes and/or peritoneal macrophages, cervical and inguinal lymph nodes were subjected to histologic examination. Labeled cells of all cell types were found in the cervical lymph nodes, but they were not observed in the inguinal lymph nodes. No labeled cells were demonstrated in the lymph nodes following intravenous injection of cell suspensions. It is assumed that an efflux of cells occurs in the perineural spaces of the exiting nerve fibers. The anatomic relationships were discussed.

Longitudinal spread of intraneurally injected local anesthetics. An experimental study of the initial neural distribution following intraneural injections

Unexpected spinal anesthesia, occurring after peripheral nerve blocks close to the spine, may be caused by a centripetal spread of the local anesthetic along the injected nerve to the spinal cord. In order to analyze the pathway of such a spread, a radioactive local anesthetic mixed with a fluorescent dye was injected into difrerent compartments of the rabbit sciatic nerve, and the early distribution of these tracers was studied by scintillation counting and fluorescence microscopy. Epineurial (extrafascicular) injections were of low injection pressure (25-60 mmHg) (3.3-7.9 kPa) and limited spread, while endoneurial (intrafascicular) injections reached higher pressures (300-750 mmHg) (39.9-99.7 kPa) and caused a rapid spread over long distances within the fascicle. The sacral plexus seemed difficult to pass. However, 20% of endoneurial injections reached the spinal cord, where the injectate primarily spread in the thin subpial space. Our experimental findings suggest that intraneural injections of local anesthetics are responsible for the reported cases of unexpected spinal anesthesia due to inadvertent intrafascicular spread. Although intrafascicular injections are rarely made, we recommend that intraneural injections of local anesthetics or other solutions close to the spine should be avoided, as they may cause unexpected spinal anesthesia or lesion of the cord.

Developmental morphology of the subarachnoid space and contiguous structures in the mouse

Development of pia-arachnoidal membranes in the mouse occurs in four stages: the first (prenatal days 10-13) follows closure of the neural tube and is a period of initial vascularization of the developing telencephalon; the second (prenatal days 14-16) is a period of delineation during which the limits of the subarachnoid space are defined; the third (prenatal day 17 to birth) is a period of ensheathment of pia-arachnoidal blood vessels; and the fourth (birth to postnatal day 21) includes addition of smooth muscle to larger vessels, the appearance of macrophages in the subarachnoid space, and a general increase in extracellular collagenous and elastic fibers. The mesenchyme over the telencephalic surface in the 10-day fetus has a typically large extracellular space. By the 13th fetal day cerebrospinal fluid begins to seep into and replace it. The mesenchymal extracellular compartment is reduced peripherally, resulting in a compacted pia-arachnoidal tissue which limits the peripheral extent of the subarachnoid space. By the 21st postnatal day a subarachnoid space typical of the adult animal has been established.

Herpes genitalis in guinea-pigs. II. Morphological studies in female guinea-pigs infected with Herpesvirus hominis type 2

Gross and microscopial morphological changes developing in female guinea-pigs after vaginal infection with HVH 2/Angelotti were studied. In the mucosa of the external genital tract there were inflammatory changes with formation of intra-epithelial vesicles, erosions and ulcerations. In the late stages of the infection signs of inflammatory dysplasia were also observed. The infection spread into the nervous system and produced characteristic inflammatory changes. The inflammation began as a bilateral posterior myelitis and ascended in the course of infection through the upper spinal-cord towards the brain-stem. The morphological changes were preceded by increased virus replication in the respective tissues and were correlated in time with clinical symptoms. The morphological changes seen at the site of inoculation in the external genital tract of the guinea-pig bore a certain resemblance to those seen in some cases of human infection with the same type of virus.