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Head injuries
Published in Alexander Trevatt, Richard Boulton, Daren Francis, Nishanthan Mahesan, Take Charge! General Surgery and Urology, 2020
Blood is present between the arachnoid mater and pia mater. Traumatic causes can occur in any age group, whilst rupture of aneurysms tends to occur in patients under 60. Patients describe a sudden, severe headache (‘thunderclap’ headache), and this can be associated with vomiting episodes and neck stiffness, which can be confused for meningitis. A non-contrast CT head is highly sensitive and blood appears most commonly in the cerebral sulci in traumatic cases.
The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
The brain and spinal cord are enclosed by three membranous layers collectively referred to as the meninges; these comprise the dura mater, arachnoid mater and pia mater. The dura mater acts as the periosteum to the skull and spine. Extensions of the dura – the falx cerebri and the tentorium cerebelli (Figure 12.1) – subdivide the cranial cavity into three spaces, two supratentorial and one infratentorial (the posterior fossa). The subdural space lies between the dura and the outer surface of the arachnoid, and blood or pus can spread widely throughout it. The arachnoid lies in contact with the dura; the pia is closely attached to the brain. The subarachnoid space is filled with cerebrospinal fluid (CSF). It is widest in the basal cisterns and within sulci. It contains the major cerebral arteries and veins, branches from which pass to and from the brain.
Treatment of symptomatic cervical and lumbar pseudomeningocoeles
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Joshua E. Heller, George Rymarczuk
In some cases, the dural may be violated, but the underlying arachnoid mater may remain intact. Frequently, blebbing of arachnoid can be seen herniating through the dural defect. No high-quality literature exists regarding the treatment of this. With the dural violation, there probably is a higher rate of CSF leakage through a rupture of the arachnoid, and thus the authors recommend that this entity be repaired. It is very easy to instigate a CSF leak through the careless placement of an instrument of suction device when managing an arachnoid bleb.
Choroid plexus and CSF: an updated review
Published in British Journal of Neurosurgery, 2022
Dana Hutton, Mohammed Gadoora Fadelalla, Avinash Kumar Kanodia, Kismet Hossain-Ibrahim
NPH is a condition clinically characterised by the triad of: dementia, gait disturbance, and urinary incontinence. It presents similarly to other dementias, however brain imaging reveals ventriculomegaly without concomitant cerebral atrophy.33 NPH has been assumed to result from insufficient CSF reabsorption of the arachnoid granulations. This can occur secondary to thickening of the arachnoid mater from previous subarachnoid haemorrhage or meningitis. However, in most cases the cause remains uncertain – idiopathic NPH (INPH). Whatever the cause of NPH, slight transmantle pressure gradients arise, and cause hyperdynamic CSF flow through the aqueduct. NPH can still be termed ‘normal’ pressure despite being at a new, higher level, as over time CSF formation is dampened to achieve a stable state.33 CT features of NPH have been demonstrated in Figure 3.
Cerebrospinal fluid leaks secondary to dural tears: a review of etiology, clinical evaluation, and management
Published in International Journal of Neuroscience, 2021
Jason Gandhi, Andrew DiMatteo, Gunjan Joshi, Noel L. Smith, Sardar Ali Khan
The meninges are composed of three membrane structures that encapsulate the brain and spinal cord. The three membranes of the meninges from most superficial to deep are respectively the: dura, arachnoid, and pia mater. The dura mater is also referred to as the pachymeninx or “thick meninx”, while the pia and arachnoid mater collectively are referred to as the leptomeninx or “thin meninx” [5]. The dura itself is composed of three layers: the most superficial layer called the endosteal (i.e. periosteal), the meningeal layer, and the deepest layer called the dural border cell layer [6,7]. The dural border cell layer interacts with the arachnoid barrier cell layer and basement membrane of the arachnoid mater. It is in the arachnoid reticular layer and subarachnoid space that the CSF is contained. The depth of the subarachnoid space is variable depending on the relationship between the arachnoid and pia mater [7].
The role of exosomes derived from cerebrospinal fluid of spinal cord injury in neuron proliferation in vitro
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2018
Fan-Long Kong, Xiao-Ping Wang, Ya-Nan Li, Hai-Xu Wang
Spinal cord injury (SCI) is a very severe disorder that can be caused by trauma ranging from traffic accidents to war wounds. SCI results in neuronal degeneration and demyelination due to oligodendrocyte apoptosis at the region of trauma, which causes severe functional impairment of motor and sensory pathways [1]. Cerebrospinal fluid (CSF) is a clear, colorless body fluid found in the brain and spine. It is produced in the choroid plexuses of the ventricles of the brain. It acts as a cushion or buffer for the brain's cortex, providing basic mechanical and immunological protection to the brain inside the skull. The CSF occupies the subarachnoid space (between the arachnoid mater and the pia mater) and the ventricular system around and inside the brain and spinal cord. It constitutes the content of the ventricles, cisterns and sulci of the brain, as well as the central canal of the spinal cord. The physical condition and biological composition of CSF was changed when SCI had happened in body.