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MATSUMAE M, SATO O, HIRAYAMA A, HAYASHI N, TAKIZAWA K, ATSUMI H, SORIMACHI T. Research into the Physiology of Cerebrospinal Fluid Reaches a New Horizon: Intimate Exchange between Cerebrospinal Fluid and Interstitial Fluid May Contribute to Maintenance of Homeostasis in the Central Nervous System. Neurol Med Chir (Tokyo) 2016; 56:416-41. [PMID: 27245177 PMCID: PMC4945600 DOI: 10.2176/nmc.ra.2016-0020] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 03/20/2016] [Indexed: 12/23/2022] Open
Abstract
Cerebrospinal fluid (CSF) plays an essential role in maintaining the homeostasis of the central nervous system. The functions of CSF include: (1) buoyancy of the brain, spinal cord, and nerves; (2) volume adjustment in the cranial cavity; (3) nutrient transport; (4) protein or peptide transport; (5) brain volume regulation through osmoregulation; (6) buffering effect against external forces; (7) signal transduction; (8) drug transport; (9) immune system control; (10) elimination of metabolites and unnecessary substances; and finally (11) cooling of heat generated by neural activity. For CSF to fully mediate these functions, fluid-like movement in the ventricles and subarachnoid space is necessary. Furthermore, the relationship between the behaviors of CSF and interstitial fluid in the brain and spinal cord is important. In this review, we will present classical studies on CSF circulation from its discovery over 2,000 years ago, and will subsequently introduce functions that were recently discovered such as CSF production and absorption, water molecule movement in the interstitial space, exchange between interstitial fluid and CSF, and drainage of CSF and interstitial fluid into both the venous and the lymphatic systems. Finally, we will summarize future challenges in research. This review includes articles published up to February 2016.
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Affiliation(s)
- Mitsunori MATSUMAE
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa
| | | | - Akihiro HIRAYAMA
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa
| | - Naokazu HAYASHI
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa
| | - Ken TAKIZAWA
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa
| | - Hideki ATSUMI
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa
| | - Takatoshi SORIMACHI
- Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa
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Miyajima M, Arai H. Evaluation of the Production and Absorption of Cerebrospinal Fluid. Neurol Med Chir (Tokyo) 2015; 55:647-56. [PMID: 26226980 PMCID: PMC4628155 DOI: 10.2176/nmc.ra.2015-0003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The traditional hypothesis of cerebrospinal fluid (CSF) hydrodynamics presumes that CSF is primarily produced in the choroid plexus (CP), then flows from the ventricles into the subarachnoid spaces, and mainly reabsorbed in the arachnoid granulations. This hypothesis is necessary to reconsider in view of recent research and clinical observations. This literature review presents numerous evidence for a new hypothesis of CSF hydrodynamics-(1) A significantly strong relationship exists between the CSF and interstitial fluid (IF), (2) CSF and IF are mainly produced and absorbed in the parenchymal capillaries of the brain and spinal cord. A considerable amount of CSF and IF are also absorbed by the lymphatic system, and (3) CSF movement is not unidirectional flow. It is only local mixing and diffusion.
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Affiliation(s)
- Masakazu Miyajima
- Department of Neurosurgery, Juntendo University Graduate School of Medicine
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Chen L, Elias G, Yostos MP, Stimec B, Fasel J, Murphy K. Pathways of cerebrospinal fluid outflow: a deeper understanding of resorption. Neuroradiology 2014; 57:139-47. [DOI: 10.1007/s00234-014-1461-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 10/30/2014] [Indexed: 11/30/2022]
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Janssen SF, Gorgels TG, Ramdas WD, Klaver CC, van Duijn CM, Jansonius NM, Bergen AA. The vast complexity of primary open angle glaucoma: Disease genes, risks, molecular mechanisms and pathobiology. Prog Retin Eye Res 2013; 37:31-67. [DOI: 10.1016/j.preteyeres.2013.09.001] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 07/26/2013] [Accepted: 09/03/2013] [Indexed: 12/21/2022]
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Lam CH, Hansen EA, Hubel A. Arachnoid Cells on Culture Plates and Collagen Scaffolds: Phenotype and Transport Properties. Tissue Eng Part A 2011; 17:1759-66. [DOI: 10.1089/ten.tea.2010.0459] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cornelius H. Lam
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
- Minneapolis Veterans Administration Medical Center, Minneapolis, Minnesota
| | - Eric A. Hansen
- Minneapolis Veterans Administration Medical Center, Minneapolis, Minnesota
| | - Allison Hubel
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
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Trimble CR, Harnsberger HR, Castillo M, Brant-Zawadzki M, Osborn AG. "Giant" arachnoid granulations just like CSF?: NOT!! AJNR Am J Neuroradiol 2010; 31:1724-8. [PMID: 20581064 DOI: 10.3174/ajnr.a2157] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
"Giant" AGs (>1 cm) are uncommon and can be misdiagnosed as venous sinus pathology such as a neoplasm or thrombosis. Seventeen patients with a total of 19 venous sinus AGs of >1 cm were collected from contributing authors. MR imaging was available for all AGs; CT, for 5/19; and DSA, for 7/19. Intra-AG fluid was compared with CSF in subarachnoid spaces. Nonfluid AG tissue was compared with gray matter. Diagnosis was based on imaging findings. Fluid within giant AGs did not follow CSF signal intensity on at least 1 MR image in nearly 80% (15/19) of AGs. Nine of these 15 AGs had CSF-incongruent signal intensity on ≥2 MR images. CSF-incongruent signal intensity was seen in 8/8 AGs on FLAIR, 7/10 on precontrast T1WI, 13/19 on T2WI, and 8/14 on contrast-enhanced T1WI. Nonfluid signal intensity was present in 18/19 AGs and varied from absent/hypointense (intra-AG flow voids) to gray matter isointense (stromal tissue).
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Affiliation(s)
- C R Trimble
- Department of Radiological Sciences, Irvine Medical Center, University of California-Irvine, 101 The City Drive, Orange, CA 92868, USA.
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Vinchon M, Desurmont M, Soto-Ares G, De Foort-Dhellemmes S. Natural history of traumatic meningeal bleeding in infants: semiquantitative analysis of serial CT scans in corroborated cases. Childs Nerv Syst 2010; 26:755-62. [PMID: 19946689 DOI: 10.1007/s00381-009-1047-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The natural history of posttraumatic meningeal bleeding in infants is poorly documented, and the differences between inflicted head injury (IHI) and accidental trauma (AT) are debated. Autopsy findings have suggested that anoxia also plays a role in bleeding; however, these findings may not reflect what occurs in live trauma patients. PURPOSE We studied the natural history of traumatic meningeal bleeding in infants using serial computed tomography (CT) scans in corroborated IHI and AT. MATERIALS AND METHODS From our prospective series, we selected corroborated cases (confessed IHI or AT having occurred in public), who underwent at least three CT scans in the acute phase. We performed a semiquantitative analysis of meningeal bleeding using a four-tier scale (absent, faint, frank, and thick) derived from the Fisher grading for aneurysmal bleeding in four regions of interest (convexity, falx cerebri, sagittal sinus, and tentorium cerebelli). RESULTS We studied 20 cases: ten IHI and ten AT. Bleeding was maximal at the convexity initially, then increased along the falx and sagittal sinus, and then along the tentorium. Decrease and disappearance of blood was variable according to the site and the initial quantity of blood. We found no difference between IHI and AT. CONCLUSION Our findings suggest that the primary site of meningeal bleeding in infantile head trauma is the convexity of the brain; blood cells then migrate toward the midline following the flow of cerebrospinal fluid circulation and inferiorly following gravity. The pattern of bleeding in traumatic cases appears similar in IHI and AT but different from anoxic lesions.
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Affiliation(s)
- Matthieu Vinchon
- Department of Pediatric Neurosurgery, Lille University Hospital, 59 037, Lille Cedex, France.
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Holman DW, Kurtcuoglu V, Grzybowski DM. Cerebrospinal fluid dynamics in the human cranial subarachnoid space: an overlooked mediator of cerebral disease. II. In vitro arachnoid outflow model. J R Soc Interface 2010; 7:1205-18. [PMID: 20335192 DOI: 10.1098/rsif.2010.0032] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The arachnoid membrane (AM) and granulations (AGs) are important in cerebrospinal fluid (CSF) homeostasis, regulating intracranial pressure in health and disease. We offer a functional perspective of the human AM's transport mechanism to clarify the role of AM in the movement of CSF and metabolites. Using cultures of human AG cells and a specialized perfusion system, we have shown that this in vitro model mimics the in vivo characteristics of unidirectional fluid transport and we present the first report of serum-free permeability values (92.5 microl min(-1) mm Hg(-1) cm(-2)), which in turn are in agreement with the CSF outflow rates derived from a dynamic, in vivo magnetic resonance imaging-based computational model of the subarachnoid cranial space (130.9 microl min(-1) mm Hg(-1) cm(-2)). Lucifer yellow permeability experiments have verified the maintenance of tight junctions by the arachnoidal cells with a peak occurring around 21 days post-seeding, which is when all perfusion experiments were conducted. Addition of ruthenium red to the perfusate, and subsequent analysis of its distribution post-perfusion, has verified the passage of perfusate via both paracellular and transcellular mechanisms with intracellular vacuoles of approximately 1 microm in diameter being the predominant transport mechanism. The comparison of the computational and in vitro models is the first report to measure human CSF dynamics functionally and structurally, enabling the development of innovative approaches to modify CSF outflow and will change concepts and management of neurodegenerative diseases resulting from CSF stagnation.
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Affiliation(s)
- David W Holman
- Biomedical Engineering Department, Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
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Histopathology of the arachnoid granulations and brain in HIV-associated cryptococcal meningitis: correlation with cerebrospinal fluid pressure. AIDS 2010; 24:405-10. [PMID: 19952714 DOI: 10.1097/qad.0b013e328333c005] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the histopathology of the arachnoid granulations in patients with HIV-associated cryptococcal meningitis and correlate the findings with clinical data, in particular cerebrospinal fluid (CSF) opening pressure. DESIGN Case series. METHODS Postmortems were requested on patients dying during initial hospitalization with HIV-associated cryptococcal meningitis. RESULTS Five postmortems were performed. Large numbers of cryptococcal cells were seen within the arachnoid granulations. The number of fungal cells correlated with CSF pressure. Inflammatory cell infiltrates and disruption of the normal architecture of the granulations were also observed. CONCLUSION The study provides the first direct evidence supporting the obstruction to CSF reabsorption at the level of the arachnoid granulations as the main mechanism underlying the development of raised CSF pressure in HIV-associated cryptococcal meningitis.
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Kapoor KG, Katz SE, Grzybowski DM, Lubow M. Cerebrospinal fluid outflow: an evolving perspective. Brain Res Bull 2008; 77:327-34. [PMID: 18793703 DOI: 10.1016/j.brainresbull.2008.08.009] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2008] [Accepted: 08/08/2008] [Indexed: 11/16/2022]
Abstract
Cerebrospinal fluid (CSF) serves numerous important functions in the central nervous system. Despite numerous reports characterizing CSF and its circulation in the subarachnoid space, our understanding of CSF outflow remains limited. Although initial work suggested that both arachnoid granulations and lymphatic capillaries shared in the role of CSF outflow, predominant work since then has focused on the arachnoid granulations. A growing body of recent evidence not only suggests the importance of both arachnoid granulations and lymphatic capillaries, but also additional contributions through transependymal passage likely share in the role of CSF outflow. Consideration of all mechanisms and pathways will help us to better understand the significance of CSF outflow, in health and disease. Here we review how the present concept of CSF outflow has evolved, including a historical review of significant findings and a discussion of the latest innovative developments.
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Affiliation(s)
- Kapil G Kapoor
- Department of Ophthalmology, Ohio State University, Columbus, OH, USA.
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Mehta BC, Holman DW, Grzybowski DM, Chalmers JJ. Characterization of arachnoidal cells cultured on three-dimensional nonwoven PET matrix. ACTA ACUST UNITED AC 2007; 13:1269-79. [PMID: 17518753 DOI: 10.1089/ten.2006.0233] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To culture physiologically functional primary arachnoidal cells on a suitable polymer substrate for an in-vitro model of the cerebrospinal fluid outflow pathway. METHODS Primary cultures of arachnoidal cells were prepared within 24 hours post-mortem from brain tissue obtained from human cadavers at autopsy. Arachnoidal cells were characterized using immunocytochemistry and seeded onto needle punched non-woven poly(ethylene terephthalate)(PET) scaffolds. Metabolic rate, cell growth rate in log phase, morphologic assessment, immunocytochemistry, and protein analysis were used to characterize the cultures in both 2-D and 3-D-culture. Functional outflow assessment was performed using the Lucifer Yellow (LY) permeability assay and hydraulic conductivity (Lp) determination. RESULTS Cells cultured on PET scaffold grew slightly slower than cells grown in 2-D-culture as measured by metabolic rate and growth rate, however, they often formed sheets that bridged between the adjacent scaffold filaments forming many junctional protein connections. LY permeability coefficients of 2-D cells were compared with cells from scaffolds, and were not significantly different (p > 0.05) for both culture conditions. Average Lp of cells from 2-D-culture and 3-D-scaffolds were compared and shown not to be significantly different. CONCLUSION Based on the biochemical and functional analysis, it has been shown that cells cultured on 3D-PET scaffolds retained the same properties as cells from 2D-culture plates.
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Affiliation(s)
- Bhavya C Mehta
- Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio, USA
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Haroun AA, Mahafza WS, Al Najar MS. Arachnoid granulations in the cerebral dural sinuses as demonstrated by contrast-enhanced 3D magnetic resonance venography. Surg Radiol Anat 2007; 29:323-8. [PMID: 17483869 DOI: 10.1007/s00276-007-0211-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Accepted: 04/16/2007] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Identification of normal filling defects within the intracranial dural sinuses reduces the erroneous diagnosis of the presence of an intrasinus pathologic process. The aim of this prospective study was to assess the prevalence, distribution, and morphological characteristics of arachnoid granulations (AGs) in the dural sinuses. METHODS This prospective study was carried out on 110 patients who had both normal conventional brain MRI and contrast-enhanced (CE) 3D turbo flash magnetic resonance venography (MRV). The dural sinuses were viewed on MRV images for the presence of filling defects. The prevalence, site, size, number, shape, outlines, internal structure, and presence of associated cortical vein were determined. RESULTS One hundred and twenty-six AGs were observed among 71 patients. The superior sagittal sinus was the most common site of filling defects (58 AGs). The mean size of AGs was 6.45 +/- 3.55 mm. Eighty-three percent of AGs were round or oval, with sharp outlines and homogeneous internal structure; of these 81% were associated with cortical vein. CONCLUSIONS In the majority of cases, the identification of AGs can be facilitated by their characteristic appearances: rounded or oval shaped, well-defined outlines and homogenous intensity. The presence of an adjacent cortical vein can be considered as an additional supportive element.
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Affiliation(s)
- Azmi A Haroun
- Department of Diagnostic Radiology, Jordan University Hospital, P.O. Box 460495, 11946 Amman, Jordan.
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Holman DW, Grzybowski DM, Mehta BC, Katz SE, Lubow M. Characterization of cytoskeletal and junctional proteins expressed by cells cultured from human arachnoid granulation tissue. Cerebrospinal Fluid Res 2005; 2:9. [PMID: 16223448 PMCID: PMC1285366 DOI: 10.1186/1743-8454-2-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2005] [Accepted: 10/13/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The arachnoid granulations (AGs) are projections of the arachnoid membrane into the dural venous sinuses. They function, along with the extracranial lymphatics, to circulate the cerebrospinal fluid (CSF) to the systemic venous circulation. Disruption of normal CSF dynamics may result in increased intracranial pressures causing many problems including headaches and visual loss, as in idiopathic intracranial hypertension and hydrocephalus. To study the role of AGs in CSF egress, we have grown cells from human AG tissue in vitro and have characterized their expression of those cytoskeletal and junctional proteins that may function in the regulation of CSF outflow. METHODS Human AG tissue was obtained at autopsy, and explanted to cell culture dishes coated with fibronectin. Typically, cells migrated from the explanted tissue after 7-10 days in vitro. Second or third passage cells were seeded onto fibronectin-coated coverslips at confluent densities and grown to confluency for 7-10 days. Arachnoidal cells were tested using immunocytochemical methods for the expression of several common cytoskeletal and junctional proteins. Second and third passage cultures were also labeled with the common endothelial markers CD-31 or VE-cadherin (CD144) and their expression was quantified using flow cytometry analysis. RESULTS Confluent cultures of arachnoidal cells expressed the intermediate filament protein vimentin. Cytokeratin intermediate filaments were expressed variably in a subpopulation of cells. The cultures also expressed the junctional proteins connexin43, desmoplakin 1 and 2, E-cadherin, and zonula occludens-1. Flow cytometry analysis indicated that second and third passage cultures failed to express the endothelial cell markers CD31 or VE-cadherin in significant quantities, thereby showing that these cultures did not consist of endothelial cells from the venous sinus wall. CONCLUSION To our knowledge, this is the first report of the in vitro culture of arachnoidal cells grown from human AG tissue. We demonstrated that these cells in vitro continue to express some of the cytoskeletal and junctional proteins characterized previously in human AG tissue, such as proteins involved in the formation of gap junctions, desmosomes, epithelial specific adherens junctions, as well as tight junctions. These junctional proteins in particular may be important in allowing these arachnoidal cells to regulate CSF outflow.
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Affiliation(s)
- David W Holman
- Biomedical Engineering Center, The Ohio State University, 260 Bevis Hall, 1080 Carmack Rd, Columbus, OH 43210, USA
- Neuroophthalmic Research Group, Department of Ophthalmology, The Ohio State University, Cramblett Hall 5A, 456 W. 10th Ave., Columbus, Ohio 43210, USA
| | - Deborah M Grzybowski
- Biomedical Engineering Center, The Ohio State University, 260 Bevis Hall, 1080 Carmack Rd, Columbus, OH 43210, USA
- Neuroophthalmic Research Group, Department of Ophthalmology, The Ohio State University, Cramblett Hall 5A, 456 W. 10th Ave., Columbus, Ohio 43210, USA
| | - Bhavya C Mehta
- Department of Chemical and Biomolecular Engineering, The Ohio State University, 125A Koffolt Laboratories, 140 W. 19th Ave., Columbus, OH 43210, USA
| | - Steven E Katz
- Neuroophthalmic Research Group, Department of Ophthalmology, The Ohio State University, Cramblett Hall 5A, 456 W. 10th Ave., Columbus, Ohio 43210, USA
| | - Martin Lubow
- Neuroophthalmic Research Group, Department of Ophthalmology, The Ohio State University, Cramblett Hall 5A, 456 W. 10th Ave., Columbus, Ohio 43210, USA
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Fricke B, Andres KH, Von Düring M. Nerve fibers innervating the cranial and spinal meninges: morphology of nerve fiber terminals and their structural integration. Microsc Res Tech 2001; 53:96-105. [PMID: 11301485 DOI: 10.1002/jemt.1074] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pachymeninx and leptomeninx of cranial cavity and spine are considerably different in their collagenous fiber texture, cellular composition, vascularization, and innervation. The majority of meningeal nerve fibers terminate as free nerve endings whereas encapsulated and lamellated nerve terminals additionally occur in higher vertebrates including man. With respect to nerve fiber classification, arborization pattern, topography, and organization of the microenvironment at the termination site afferent and efferent nerve terminals are differentiated. Only the dura mater and the pial subcompartment of the leptomeninx possess the morphological prerequisites for neurogenic inflammation. In the current review, the results of morphological studies regarding the meningeal innervation including the sites of CSF (cerebrospinal fluid) production and absorption are discussed with emphasis on their structure-function relationships.
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Affiliation(s)
- B Fricke
- Department of Neuroanatomy, Institute of Anatomy, Ruhr University, Bochum, Germany.
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Yamashima T. On Arachnoid Villi and Meningiomas: Functional Implication of Ultrastructure, Cell Adhesion Mechanisms, and Extracellular Matrix Composition. Pathol Oncol Res 2001; 2:144-149. [PMID: 11173597 DOI: 10.1007/bf02903517] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Arachnoid villi or granulations are small projections of the arachnoid barrier layer into the venous sinus and its major tributaries. They are closely related to the absorption of cerebrospinal fluid, and are widely accepted to be the origin of human meningiomas. Arachnoid villi and meningiomas show a number of similarities in ultrastructure, cell adhesion mechanisms, and extracellular matrix composition. Ultrastructurally, both arachnoid and meningioma cells are characterized by interdigitations connected with junctional complexes, and extracellular cisterns related to the fluid transport. Extracellular cisterns and the intercellular space reveal abundant membrane-derived multilamellar phospholipids when a conventional ultrastructural fixative supplemented with tannic acid is used. Both arachnoid and meningioma cells are connected by Ca2+-dependent adhesion molecules: epithelial-cadherins which are concentrated at the adherens junctions. Membrane-cytoskeleton interactions by means of merlin and a-catenin molecules are thought to be crucial in signal transduction resulting in contact inhibition of cell growth in normal arachnoid cells. Impairment of these molecules might be related to meningioma-genesis. Glutathione-independent prostaglandin D2 synthase [EC 5.3.99.2] responsible for the biosynthesis of prostaglandin D2 in the central nervous system is also consistently expressed in human arachnoid villi and meningiomas. The multilamellar phospholipids are conceivably related to this arachidonate metabolism.
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Affiliation(s)
- Tetsumori Yamashima
- Kanazawa University School of Medicine, Department of Neurosurgery, Kanazawa, Japan
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Massicotte EM, Del Bigio MR. Human arachnoid villi response to subarachnoid hemorrhage: possible relationship to chronic hydrocephalus. J Neurosurg 1999; 91:80-4. [PMID: 10389884 DOI: 10.3171/jns.1999.91.1.0080] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECT The origin of chronic communicating hydrocephalus following subarachnoid hemorrhage (SAH) is not well understood. Fibrosis of the arachnoid villi has been suggested as the cause for obstruction of cerebrospinal fluid (CSF) flow, but this is not well supported in the literature. The goal of this study was to determine the relationship between blood, inflammation, and cellular proliferation in arachnoid villi after SAH. METHODS Arachnoid villi from 50 adult patients were sampled at autopsy. All specimens were subjected to a variety of histochemical and immunohistochemical stains. The 23 cases of SAH consisted of patients in whom an autopsy was performed 12 hours to 34 years post-SAH. Fifteen cases were identified as moderate-to-severe SAH, with varying degrees of hydrocephalus. In comparison with 27 age-matched non-SAH controls, the authors observed blood and inflammation within the arachnoid villi during the 1st week after SAH. Greater mitotic activity was also noted among arachnoid cap cells. The patient with chronic SAH presented with ventriculomegaly 2 months post-SAH and exhibited remarkable arachnoid cap cell accumulation. CONCLUSIONS The authors postulate that proliferation of arachnoidal cells, triggered by the inflammatory reaction or blood clotting products, could result in obstruction of CSF flow through arachnoid villi into the venous sinuses. This does not exclude the possibility that SAH causes generalized fibrosis in the subarachnoid space.
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Affiliation(s)
- E M Massicotte
- Department of Surgery, University of Manitoba and Health Sciences Centre, Winnipeg, Canada
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Miranda-Neto MH, Brancalhão RM, Chopard RP, Molinari SL. [Morphological study of human arachnoid granulations with reference to their classification]. ARQUIVOS DE NEURO-PSIQUIATRIA 1994; 52:41-5. [PMID: 8002806 DOI: 10.1590/s0004-282x1994000100007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Stereomicroscopic and microscopic study showed human arachnoid granulations with different morphology that we classified in simple and lobate. Simple granulations were small and completely involved by fibrous capsule that delimited a continuous subdural space from the pedicle to the apex. Lobate granulations were bigger than the simple; in the apex the fibrous capsule was thinner than in other regions, and fused with granulation periphery causing interruption of subdural space. Simple granulations might be an initial development stage; lobate granulations would represent a higher development stage, with ideal morphologic structure for absorption of the CSF.
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Affiliation(s)
- M H Miranda-Neto
- Departamentos de Ciências Morfofisiológicas, Universidade Estadual de Maringá (UEM), Maringá PR, Brasil
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Takahashi Y, Inokuchi T, Shigemori M. The ultrastructure of the primate arachnoid granulation, studied with the scanning and transmission electron microscopes. ACTA ACUST UNITED AC 1993. [DOI: 10.1007/bf02347996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chopard RP, Brancalhão RC, Miranda-Neto MH, Biazotto W. Arachnoid granulation affected by subarachnoid hemorrhage. ARQUIVOS DE NEURO-PSIQUIATRIA 1993; 51:452-6. [PMID: 8147744 DOI: 10.1590/s0004-282x1993000400005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The purpose of this study was to investigate using light microscopy the fibrocellular components of arachnoid granulations affected by mild and severe subarachnoid hemorrhage. The erythrocytes were in the channels delimited by collagenous and elastic bundles and arachnoid cells, showing their tortuous and inter-communicating row from the pedicle to the fibrous capsule. The core portion of the pedicle and the center represented a principal route to the bulk outflow of cerebrospinal fluid and erythrocytes. In the severe hemorrhage, the fibrocellular components are disorganized, increasing the extracellular channels. We could see arachnoid granulations without erythrocytes, which cells showed big round nucleus suggesting their transformation into phagocytic cells.
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Affiliation(s)
- R P Chopard
- Departamento de Anatomia, Universidade de São Paulo (USP), Brasil
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Yamashima T, Tohma Y, Yamashita J. Expression of cell adhesion molecule E-cadherin in human arachnoid villi. J Neurosurg 1992; 77:749-56. [PMID: 1403118 DOI: 10.3171/jns.1992.77.5.0749] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Calcium-dependent epithelial cell adhesion molecules designated as E-cadherin (also known as uvomorulin or L-CAM) were identified in human arachnoid villi by immunoblotting and immunocytochemical analyses using a monoclonal antibody HECD-1 raised against human mammary carcinoma MCF-7 cells. Immunoblot analysis showed that HECD-1 recognizes E-cadherin with a molecular weight of 124 kD. In all arachnoid cells of an arachnoid villus, E-cadherin was detected by immunolight microscopy within the cytoplasm rather than the cellular boundaries as seen in the control group. Furthermore, the extent of expression by immunolight microscopy varied from portion to portion. The expression was usually weak in the syncytial cluster which was ultrastructurally composed of tightly juxtaposed cells characterized by few extracellular cisterns and numerous cell junctions, while it was intense in the reticular cluster and the surface layer which were ultrastructurally characterized by abundant extracellular cisterns and smaller numbers of cell junctions. The cells of the reticular cluster and the surface layer contained more free ribosomes than those of the syncytial cluster. Immunoelectron microscopy showed that E-cadherin was localized not only to the opposing plasma membranes and the cytoplasm around the free ribosomes or the rough endoplasmic reticulum but also to the extracellular cisterns. As the expression of E-cadherin was closely related to the arachnoid cells adjacent to the cerebrospinal fluid pathway, it is suggested that, instead of the cell junctions, E-cadherin may play an important role in the flexible adhesion of arachnoid cells even in the presence of the cerebrospinal fluid.
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Affiliation(s)
- T Yamashima
- Department of Neurosurgery, University of Kanazawa School of Medicine, Japan
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Binhammer RT. CSF Anatomy with Emphasis on Relations to Nasal Cavity and Labyrinthine Fluids. EAR, NOSE & THROAT JOURNAL 1992. [DOI: 10.1177/014556139207100703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Robert T. Binhammer
- Department of Anatomy, University of Nebraska College of Medicine, Omaha, NE 68198-6395
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Abstract
A case report and review of the temporal bone (TB) collection in the Department of Otolaryngology at SUNY Health Science Center in Syracuse demonstrated the occurrence of arachnoid granulations (AGs) in the posterior fossa surface of the TB and their role in cerebrospinal fluid (CSF) otorrhea. A large AG responsible for CSF otorrhea in a 64-year-old man was excised with soft tissue repair of the dural defect. Sixteen of 188 TBs (8.5%) in the collection contained 24 AGs ranging in size from 0.07 to 80.65 mm3. Nine AGs (37%) were small (less than 1 mm3) and did not demonstrate enlargement. Twelve (50%) were of intermediate size (2.50 to 9.32 mm3), and three (13%) were large (49.82 to 80.65 mm3). The intermediate and large AGs were associated with bone erosion and a high incidence of communication with a pneumatized mastoid complex (serous otitis media or meningitis). These findings suggest that AGs of sufficient size to produce bone erosion are the primary responsible lesions in adult-onset spontaneous CSF otorrhea.
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Affiliation(s)
- R R Gacek
- Department of Otolaryngology and Communication Sciences, SUNY Health Science Center, Syracuse 13210
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Kida S, Yamashima T, Kubota T, Ito H, Yamamoto S. A light and electron microscopic and immunohistochemical study of human arachnoid villi. J Neurosurg 1988; 69:429-35. [PMID: 3404241 DOI: 10.3171/jns.1988.69.3.0429] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The structure of human arachnoid villi was investigated by light and electron microscopy with the aid of immunohistochemical techniques. The human arachnoid villi examined were basically composed of four portions: a fibrous capsule, an arachnoid cell layer, a cap cell cluster, and a central core. The arachnoid cell layer encompassing the central core was mostly covered by the thin fibrous capsule with an endothelial investment. However, the fibrous capsule was often absent at the apical portion of the villus and a factor VIII-related antigen stain failed to confirm the investment of endothelial cells. Instead, the arachnoid cell layer abutted directly upon the lumen of a lateral lacuna or the sinus. The arachnoid cell layer was thickened in places, forming cap cell clusters; it usually consisted of outer and inner zones. On vimentin staining, the former was slightly positive while the latter was strongly positive. The central core contained a network of arachnoid cells intermingled with connective tissue fibers and was in continuity with the cranial subarachnoid space. Electron microscopy showed that the arachnoid cells contained a larger number of intermediate filaments in the inner zone than the outer zone. Ultrastructural immunohistochemical localization showed that vimentin was localized at the intermediate filaments and desmosomal plaques of the arachnoid cells. The arachnoid cells showed a marked variety in both the cell forms and the number of intermediate filaments or desmosomes, depending on their location.
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Affiliation(s)
- S Kida
- Department of Neurosurgery, University of Kanazawa School of Medicine, Japan
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Abstract
Vibrations of human skull, as produced by loud vocalisation, exert a massaging effect on the brain and facilitate elution of metabolic products from the brain into the cerebrospinal fluid (CSF). In addition, these vibrations, through their effect on arachnoid villi, speed up the flow of CSF from the subarachnoid space into the blood within the superior sagittal sinus and lacunae lateralis. In this way, the speed of renewal of CSF is increased, which again contributes to a faster cleaning process of the brain. The most important feature of human evolution is enlargement of the brain. This by itself would not be enough. The Neandertals had a brain 15% larger than we have, yet they did not survive in competition with modern humans. Their brains were more polluted, because their massive skulls did not vibrate and therefore the brains were not sufficiently cleaned. In the evolution of modern humans the thinning of cranial bones was important. In addition, the chin remained jutting out of the face as in no other hominids, in order to maintain the distance from the chin to the hyoid bone equal to the distance from the latter to the styloid process. This situation facilitates transmission of laryngeal vibrations onto the skull base via the mandible.
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Affiliation(s)
- K F Jindrak
- Methodist Hospital, Brooklyn, New York, 11215
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