Search results for "Subarachnoid space"
showing 10 items of 18 documents
Introducing the concept of “CSF-shift edema” in traumatic brain injury
2018
Brain edema after severe traumatic brain injury (TBI) plays an important role in the outcome and survival of injured patients. It is also one of the main targets in the therapeutic approach in the current clinical practice. To date, the pathophysiology of traumatic brain swelling is complex and, being that it is thought to be mainly cytotoxic and vasogenic in origin, not yet entirely understood. However, based on new understandings of the hydrodynamic aspects of cerebrospinal fluid (CSF), an additional mechanism of brain swelling can be considered. An increase in pressure into the subarachnoid space, secondary to traumatic subarachnoid hemorrhage, would result in a rapid shift of CSF from t…
Cisternostomy for Traumatic Brain Injury: Pathophysiologic Mechanisms and Surgical Technical Notes
2016
Objective Traumatic brain injury (TBI) is one of the major challenges in health care, representing the third most frequent cause of death. Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies. Here we describe cisternostomy, an emerging surgical treatment for the treatment of TBI. Methods Cisternostomy is a novel technique that incorporates knowledge of skull base and microvascular surgery. By opening the brain cisterns to atmospheric pressure, the technique could decrease the intracranial pressure due to a backshift of the cerebrospinal fluid (CSF) from the swollen brain to the cisterns through the Virchow-Rob…
Do spinal meningiomas penetrate the pial layer? Correlation between magnetic resonance imaging and microsurgical findings and intracranial tumor inte…
1997
OBJECTIVE: To study the relationships between spinal dura-arachnoid and tumor-cord interfaces in spinal meningiomas and to investigate whether a disruption of the pial layer and penetration of the tumor in the spinal cord occurs. METHODS: Fifteen patients with histologically proven meningiomas underwent magnetic resonance imaging (MRI) preoperatively. All patients underwent microsurgery. The histological characteristics of the tumors were compared with MRI and microsurgical findings. RESULTS: At surgery, the peritumoral hypointense rim revealed by MRI in 10 of 15 patients corresponded to a well-defined cerebrospinal fluid-containing space confined between the outer arachnoidal layer and the…
Management of cerebrospinal fluid otorrhea.
2013
Abstract Introduction Cerebrospinal fluid otorrhea results from an abnormal communication between the subarachnoid space and tympanomastoid compartment; most of them are of traumatic aetiology. They have clinical interest due to the potential risk of meningitis, directly related to the aetiology. Our aim was to show our experience in the management of this process. Methods A total of 17 patients were diagnosed and treated for cerebrospinal fluid otorrhea from 2003 to 2011. Results In our study, the highest percentage of cases was spontaneous cerebrospinal fluid otorrhea, with a wide clinical presentation. The diagnosis was based on the determination of beta-2-transferrin and radiological st…
Endoscopic and endoscope-assisted neurosurgical treatment of suprasellar arachnoidal cysts (Mickey Mouse cysts).
2005
Suprasellar arachnoid cysts represent less than 10% of all intracranial arachnoid cysts. Some of them may be quiescent throughout life, some may become symptomatic as they become enlarged and some disappear spontaneously. In this study we discuss the surgical strategies for endoscopic and endoscope-assisted treatment of suprasellar (Mickey Mouse) cysts and analyze the clinical results and experience collected over some years in our department upon doing these operations routinely. Between December 1996 and December 2003, 13 patients (7 female and 6 male patients), mean age 29 years, underwent endoscopic or endoscope-assisted procedures for suprasellar cysts at our department. The indication…
Biportal neuroendoscopic microsurgical approaches to the subarachnoid cisterns. A cadaver study.
1996
A preclinical cadaver study was performed to develop the technique of biportal neuroendoscopic dissection in the subarachnoid space of the basal cisterns and to test the feasibility, utility, and safety of this new technique. In 23 fresh post-mortem adult human cadavers and 2 formalin-fixed adult human head specimen a total of 33 biportal endomicrosurgical dissections into and within the basal cisterns were carried out. Following suction of cerebrospinal fluid from the subarachnoid space 0 degree-, 30 degrees-, and 70 degrees-lens-scopes (Aesculap AG, Tuttlingen, Germany) with outer diameters of 4.2 mm and trochars with outer diameters of 5 to 6.5 mm were introduced into the surgical field.…
The pia mater at the site of the entry of blood vessels into the central nervous system
1982
The entry of blood vessels into the central nervous system (CNS) has been studied at the surface of the brain stem and the spinal cord of two cats and two rabbits. The study was carried out by scanning electron microscopy (SEM). The results obtained by SEM concerning the layers of the pia mater corresponded to those obtained by other authors who used transmission electron microscopy. Between the basal lamina of the superficial glial membrane of the CNS and the cells lining the subarachnoid space, a pial connective tissue space could be clearly recognized. The blood vessles crossing the subarachnoid space were also covered by leptomeningeal lining cells. At the site of entry of these blood v…
Dural sac localization using myelography and its application to the lumbosacral epidural in dogs
2020
Background: The techniques described for the identification of the lumbosacral (LS) epidural space in dogs do not guarantee the needle position or an accidental subarachnoid puncture, especially in small size dogs.Aim: To determine the relationship between body weight and the location of the dural sac (DS) using myelography in dogs, and to determine the possibility of subarachnoid puncture during LS epidural based on the position of the DS.Methods: Four masked observers evaluated 70 myelographic studies of dogs, annotating the vertebrae where the DS ended, if it was localized before or after the LS space, and if accidental subarachnoid puncture during LS epidural injection was possible (yes…
Intracranial Pressure and Mass Displacements of the Intracranial Contents
1976
The brain is completely surrounded by the bony skull and its closely adherent, tough, dural inner lining. This converts the enclosed space into a watertight chamber with the exception of the small, basally situated foramen magnum. In adults, these factors combine to prevent the skull from expanding. Consequently, the intracranial volume cannot fluctuate. In addition, the intracranial contents — blood, brain, and spinal fluid — are essentially noncompressible.
Phagocytosis of erythrocytes in the subarachnoid space at spinal nerve exits
1982
After intracisternal injection of heparinised autologous blood in cats, spinal nerve exits (SNE) of the subarachnoid space (SAS) were examined by scanning and transmission electron microscopy. Phagocytes, erythrocytes and erythrophages (= macrophages which had phagocytosed red blood cells) were found at SNE. Some lining cells of the SAS had retracted from the adjacent cells and had rounded up. Cells which formed an integral part of the subarachnoid lining cells also had phagocytosed erythrocytes. Debris of an exhausted erythrophage was phagocytosed by other macrophages. Finally the observation has been made that erythrophages are capable of leaving the SAS actively by migrating through the …