Unlabelled: Previous studies of samples from cranial meninges have created doubts about the existence of a virtual subdural space. We examined the ultrastructure of spinal meninges from three human cadavers immediately after death to see whether there is a virtual subdural space at this level. The arachnoid mater had two portions: a compact laminar portion covering the dural sac internal surface and a trabecular portion extending like a spider web around the pia mater. There was a cellular interface between the laminar arachnoid and the internal layer of the dura that we called the dura-arachnoid interface. There was no subdural space in those specimens where the dura mater was macroscopically in continuity with the arachnoid trabecules. In the specimens where the dura mater was separated from the arachnoid, we found fissures in between the neurothelial cells that extended throughout the interface. We hypothesize that the subdural space would have its origin within the dura-arachnoid interface when the neurothelial cells break up, creating in this way a real subdural space.
Implications: The subdural space was not seen under transmission electron microscopy in samples of human spinal meninges where surgical manipulation was avoided. Scanning electron microscopy in other samples showed the presence of broken neurothelial cells giving up fissures that extended along the dura-arachnoid interface. These findings may explain the origin of a real subdural space.
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http://dx.doi.org/10.1097/00000539-200204000-00040 | DOI Listing |
Chin Neurosurg J
December 2024
Department of Neurosurgery, Hebei Children's Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.
Background: A nonadjustable state of the programmable shunt valve is a rare phenomenon. This case report aims to explore the cause of pressure adjustment dysfunction in a programmable shunt valve in a middle cranial fossa arachnoid cyst-peritoneal shunt patient and to underscore this dysfunction as an indicator of shunt valve obstruction.
Case Presentation: A child with a ruptured giant arachnoid cyst in the left middle cranial fossa presented with acute intracranial hypertension following head trauma.
Cureus
December 2024
Pharmacology and Therapeutics, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Traumatic brain injuries (TBIs) represent a spectrum of neurological conditions resulting from external forces impacting the head, leading to temporary or permanent impairments in cognitive, emotional, or physical functioning. Acute subdural hematomas (ASDH) are a significant subset of TBIs characterized by the rupture of blood vessels within the subdural space between the brain and the dura mater. Management of ASDH typically involves two primary surgical procedures: craniectomy and craniotomy.
View Article and Find Full Text PDFChilds Nerv Syst
December 2024
Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Binjiang District, Hangzhou, China.
This case report presents a novel treatment approach for refractory purulent meningitis in a 1-month-old infant caused by penicillin-sensitive group B Streptococcus. Despite initial treatment with intravenous antibiotics, including penicillin and vancomycin, the infant experienced persistent symptoms and bilateral subdural effusions. Conventional therapies failed to resolve these issues, leading to the use of a new technique: subarachnoid puncture via the anterior fontanelle combined with intrathecal vancomycin administration.
View Article and Find Full Text PDFSurg Neurol Int
November 2024
Research Center, Almoosa Health Group, Al-Ahsa, Saudi Arabia.
Background: Chronic subdural hematoma (CSDH) is a prevalent neurological disorder, especially among the elderly, where blood accumulates between the brain and its outer covering. The primary treatment for CSDH involves surgical intervention, such as burr-hole craniotomy, with or without irrigation of the subdural space. The efficacy of irrigation versus no irrigation in reducing recurrence, mortality, and postoperative complications remains debated.
View Article and Find Full Text PDFSurg Neurol Int
November 2024
Department of Brain Sciences, Imperial College of London, London, United Kingdom.
Background: Neuroepithelial cysts (NECs) are rare entities, occasionally causing neurological symptoms that can be overlooked.
Case Description: A case of an occipital neuroepithelial cyst is discussed. The initial presentation consisted of mild homonymous hemianopia and gait impairment.
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