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1.
Cell ; 184(4): 1000-1016.e27, 2021 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-33508229

RESUMO

Despite the established dogma of central nervous system (CNS) immune privilege, neuroimmune interactions play an active role in diverse neurological disorders. However, the precise mechanisms underlying CNS immune surveillance remain elusive; particularly, the anatomical sites where peripheral adaptive immunity can sample CNS-derived antigens and the cellular and molecular mediators orchestrating this surveillance. Here, we demonstrate that CNS-derived antigens in the cerebrospinal fluid (CSF) accumulate around the dural sinuses, are captured by local antigen-presenting cells, and are presented to patrolling T cells. This surveillance is enabled by endothelial and mural cells forming the sinus stromal niche. T cell recognition of CSF-derived antigens at this site promoted tissue resident phenotypes and effector functions within the dural meninges. These findings highlight the critical role of dural sinuses as a neuroimmune interface, where brain antigens are surveyed under steady-state conditions, and shed light on age-related dysfunction and neuroinflammatory attack in animal models of multiple sclerosis.


Assuntos
Cavidades Cranianas/imunologia , Cavidades Cranianas/fisiologia , Dura-Máter/imunologia , Dura-Máter/fisiologia , Animais , Apresentação de Antígeno/imunologia , Células Apresentadoras de Antígenos/metabolismo , Antígenos/líquido cefalorraquidiano , Senescência Celular , Quimiocina CXCL12/farmacologia , Dura-Máter/irrigação sanguínea , Feminino , Homeostase , Humanos , Imunidade , Masculino , Camundongos Endogâmicos C57BL , Fenótipo , Células Estromais/citologia , Linfócitos T/citologia
2.
Biomed Res Int ; 2019: 7569479, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31183374

RESUMO

AIM: To present anatomic data in the ultrasound planes for the identification of the major veins and the venous sinuses in cerebrum and to establish the sonographic normal reference values for the visualization of vein vessels and vein sinuses and blood flow velocities. METHODS: This study involved 55 healthy full-term neonates for transfontanellar color Doppler sonography. The imaging included both sagittal and coronal planes with LA332E probe, supplemented with PA240 probe as necessary. As low as reasonably achievable (ALARA) principle was obeyed, limiting Doppler exposure time and maximizing signal intensity by increasing gain rather than outputting transducer power settings. The output power was kept at a minimum level consistent with recording an adequate signal. Keeping the newborns in calm state, the total examination time which every neonate required was less than 5 min. All images were stored also in a workstation for further analysis. The description statistics and t-test for statistical analysis were used. RESULT: In all studied cases (100% cases), subependymal veins (SV), internal cerebral veins (ICV), Galen vein (GV), straight sinus (SS), superior sagittal sinus (SSS), and transverse sinuses (TS) were visualized. The visualization percentages of inferior sagittal sinus (ISS) or basal veins/Rosenthal veins (BV/RV) were lower than 100%. Based on vessel visualization percentage from high to low, the vessels were ordered as follows: SV, ICV, BV, SS, TS, ISS, and SSS. In SSS and TS, the pulsation percentage was 100%. The descending percentages of vessel pulsation were noted in SS, BV, ICV, and SV. On the basis of the mean of maximum velocities of the vessels from low to high, the vessels were ordered as follows: ISS, BV-L, BV-R, ICV-R, ICV-L, SV-L, SV-R, SSS, TS-L, TS-R, and SS. CONCLUSION: The measurements percent of visualization of cerebral deep veins was higher than the percent of cerebral venous sinuses. The pulsation percent of measurement and the velocities of cerebral venous sinuses were absolutely higher than the cerebral deep venous system. The pairs of vascular blood flow velocities were nonsignificantly different from one another.


Assuntos
Sistema Cardiovascular/diagnóstico por imagem , Cérebro/diagnóstico por imagem , Cavidades Cranianas/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana , Velocidade do Fluxo Sanguíneo/fisiologia , Circulação Cerebrovascular/fisiologia , Cérebro/irrigação sanguínea , Cavidades Cranianas/fisiologia , Feminino , Humanos , Recém-Nascido , Masculino , Crânio/irrigação sanguínea , Crânio/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Veias/fisiologia
3.
Childs Nerv Syst ; 35(6): 913-916, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30929069

RESUMO

PURPOSE: There are few studies documenting the effect of posture on intracranial dural venous flow. The aim of the present study was to explore alterations caused by the prone position using magnetic resonance (MR) venography. METHODS: A total of eight patients (five men and three women) underwent non-contrast MR venography in both supine and prone positions. RESULTS: In the prone position, an increase in intracranial dural venous flow was found in all patients in the non-dominant transverse and sigmoid sinuses. An increase in venous flow to the straight sinus was observed in 75% of the patients. Flow to the superior ophthalmic vein decreased in three patients. No postural flow alterations were observed in any of the patients in the superior sagittal, dominant transverse, and sigmoid sinuses. CONCLUSION: Based on results of the study, in the prone sleeping position, part of the intracranial venous flow may be preferentially drained through the straight and non-dominant transverse sinuses.


Assuntos
Encéfalo/irrigação sanguínea , Circulação Cerebrovascular/fisiologia , Decúbito Ventral/fisiologia , Adolescente , Adulto , Angiografia Cerebral/métodos , Veias Cerebrais/fisiologia , Cavidades Cranianas/fisiologia , Dura-Máter/irrigação sanguínea , Feminino , Humanos , Angiografia por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Flebografia , Sono , Adulto Jovem
4.
J Neurointerv Surg ; 9(10): 986-989, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28360352

RESUMO

INTRODUCTION: Venous outflow obstruction has been implicated in the pathophysiology of a subset of patients with idiopathic intracranial hypertension (IIH), and venous sinus stenting (VSS) has emerged as an effective treatment. However, the effect of anesthesia on venous sinus pressure measurements is unpredictable. A more thorough understanding of the effect of the level of anesthesia on intracranial venous pressures might help to better define patients who might benefit most from stent placement. OBJECTIVE: To compare, in a retrospective cohort study, intracranial venous pressures measured under conscious (CS) sedation versus general anesthesia (GA) and to assess the relationship between anesthetic-dependent venous pressures and outcomes after VSS. METHODS: We performed a retrospective review of a prospectively maintained database to identify patients undergoing angiographic evaluation and VSS for intracranial venous stenosis. Mean venous pressures (MVPs) and trans-stenosis pressure gradients obtained under CS were compared with those measured under GA. RESULTS: The maximal MVP was significantly lower under GA (19.8 mm Hg) than CS (21.9 mm Hg; p=0.029). The MVPs in the superior sagittal sinus, torcula, and transverse sinus were lower under GA, but were significantly higher in the sigmoid sinus and jugular bulb under GA (p<0.001). The mean trans-stenosis pressure gradient was also significantly lower under GA (8.6 mm Hg) than CS (12.1 mm Hg; p<0.001). Patients with a larger difference between maximum MVP under GA versus CS were more likely to have normalization of the MVP after VSS (p=0.0008). CONCLUSIONS: Intracranial venous pressures are markedly affected by GA. In order to obtain an accurate measurement of MVPs and trans-stenosis gradients, patients undergoing investigation for IIH should undergo cerebral angiography and venous manometry under CS, which provides more reliable data for outcomes after VSS.


Assuntos
Anestesia Geral/tendências , Sedação Consciente/tendências , Cavidades Cranianas/diagnóstico por imagem , Pressão Intracraniana/fisiologia , Adolescente , Adulto , Anestesia Geral/efeitos adversos , Estudos de Coortes , Sedação Consciente/efeitos adversos , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/cirurgia , Cavidades Cranianas/fisiologia , Cavidades Cranianas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pseudotumor Cerebral/diagnóstico por imagem , Pseudotumor Cerebral/cirurgia , Estudos Retrospectivos , Seios Transversos/diagnóstico por imagem , Seios Transversos/fisiologia , Seios Transversos/cirurgia , Resultado do Tratamento , Pressão Venosa/fisiologia , Adulto Jovem
5.
AJNR Am J Neuroradiol ; 38(2): 281-287, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27932509

RESUMO

BACKGROUND AND PURPOSE: Resistance to blood flow in the cerebral drainage system may affect cerebral hemodynamics. The objective of the present study was to use phase-contrast MRA to quantify resistance to drainage of blood across branches of the venous sinus tree and to determine whether the resistance to drainage values correlated with internal jugular vein outflows. MATERIALS AND METHODS: We performed whole-head phase-contrast MRA and 2D phase-contrast MR imaging in 31 healthy volunteers. Vascular segmentation was applied to the angiograms, and the internal jugular vein velocities were quantified from the flow images. Resistance to drainage across branches of the venous sinus tree was calculated from the segmented angiograms, by using the Poiseuille equation for laminar flow. Correlations between the values of resistance to drainage and internal jugular vein outflow measurements were assessed by using the Spearman ρ. RESULTS: The overall mean resistance to drainage of the venous sinus tree was 24 ± 7 Pa s/cm3. The mean resistance to drainage of the right side of the venous sinus tree was 42% lower than that of the left side (P < .001). There were negative correlations between the values of resistance to drainage and internal jugular vein outflows on both the left side of the venous sinus tree (R = -0.551, P = .002) and the right side (R = -0.662, P < .001). CONCLUSIONS: Phase-contrast MRA is a noninvasive means of calculating the resistance to drainage of blood across the venous sinus tree. Our approach for resistance to drainage quantification may be of value in understanding alterations in the cerebral venous sinus drainage system.


Assuntos
Circulação Cerebrovascular/fisiologia , Cavidades Cranianas/diagnóstico por imagem , Cavidades Cranianas/fisiologia , Hemodinâmica/fisiologia , Angiografia por Ressonância Magnética/métodos , Adulto , Feminino , Humanos , Veias Jugulares/fisiologia , Masculino
6.
J Anat ; 228(6): 984-95, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26939052

RESUMO

The giant extinct marsupial Diprotodon optatum has unusual skull morphology for an animal of its size, consisting of very thin bone and large cranial sinuses that occupy most of the internal cranial space. The function of these sinuses is unknown as there are no living marsupial analogues. The finite element method was applied to identify areas of high and low stress, and estimate the bite force of Diprotodon to test hypotheses on the function of the extensive cranial sinuses. Detailed three-dimensional models of the cranium, mandible and jaw adductor muscles were produced. In addition, manipulations to the Diprotodon cranial model were performed to investigate changes in skull and sinus structure, including a model with no sinuses (sinuses 'filled' with bone) and a model with a midsagittal crest. Results indicate that the cranial sinuses in Diprotodon significantly lighten the skull while still providing structural support, a high bite force and low stress, indicating the cranium may have been able to withstand higher loads than those generated during feeding. Data from this study support the hypothesis that pneumatisation is driven by biomechanical loads and occurs in areas of low stress. The presence of sinuses is likely to be a byproduct of the separation of the outer surface of the skull from the braincase due to the demands of soft tissue including the brain and the large jaw adductor musculature, especially the temporalis. In very large species, such as Diprotodon, this separation is more pronounced, resulting in extensive cranial sinuses due to a relatively small brain compared with the size of the skull.


Assuntos
Força de Mordida , Cavidades Cranianas/fisiologia , Fósseis/anatomia & histologia , Marsupiais/fisiologia , Crânio/fisiologia , Animais , Fenômenos Biomecânicos , Cavidades Cranianas/anatomia & histologia , Análise de Elementos Finitos , Marsupiais/anatomia & histologia , Modelos Biológicos , Crânio/anatomia & histologia , Estresse Mecânico
7.
Eur Radiol ; 25(8): 2371-80, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25638218

RESUMO

OBJECTIVES: To visualize and quantify physiological blood flow of intracranial veins in vivo using time-resolved, 3D phase-contrast MRI (4D flow MRI), and to test measurement accuracy. METHODS: Fifteen healthy volunteers underwent repeated ECG-triggered 4D flow MRI (3 Tesla, 32-channel head coil). Intracranial venous blood flow was analysed using dedicated software allowing for blood flow visualization and quantification in analysis planes at the superior sagittal, straight, and transverse sinuses. MRI was evaluated for intra- and inter-observer agreement and scan-rescan reproducibility. Measurements of the transverse sinuses were compared with transcranial two-dimensional duplex ultrasound. RESULTS: Visualization of 3D blood flow within cerebral sinuses was feasible in 100 % and within at least one deep cerebral vein in 87 % of the volunteers. Blood flow velocity/volume increased along the superior sagittal sinus and was lower in the left compared to the right transverse sinus. Intra- and inter-observer reliability and reproducibility of blood flow velocity (mean difference 0.01/0.02/0.02 m/s) and volume (mean difference 0.0002/-0.0003/0.00003 l/s) were good to excellent. High/low velocities were more pronounced (8 % overestimation/9 % underestimation) in MRI compared to ultrasound. CONCLUSIONS: Four-dimensional flow MRI reliably visualizes and quantifies three-dimensional cerebral venous blood flow in vivo and is promising for studies in patients with sinus thrombosis and related diseases. KEY POINTS: • 4D flow MRI can be used to visualize and quantify physiological cerebral venous haemodynamics • Flow quantification within cerebral sinuses reveals high reliability and accuracy of 4D flow MRI • Blood flow volume and velocity increase along the superior sagittal sinus • Limited spatial resolution currently precludes flow quantification in small cerebral veins.


Assuntos
Veias Cerebrais/fisiologia , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Circulação Cerebrovascular/fisiologia , Cavidades Cranianas/fisiologia , Feminino , Humanos , Imageamento Tridimensional , Angiografia por Ressonância Magnética , Masculino , Imagem Multimodal , Estudos Prospectivos , Reprodutibilidade dos Testes , Trombose dos Seios Intracranianos/fisiopatologia , Ultrassonografia Doppler Dupla , Adulto Jovem
8.
PLoS One ; 9(5): e97586, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24858308

RESUMO

PURPOSE: In brain CT perfusion (CTP), the arterial contrast bolus is scaled to have the same area under the curve (AUC) as the venous outflow to correct for partial volume effects (PVE). This scaling is based on the assumption that large veins are unaffected by PVE. Measurement of the internal carotid artery (ICA), usually unaffected by PVE due to its large diameter, may avoid the need for partial volume correction. The aims of this work are to examine i) the assumptions behind PVE correction and ii) the potential of selecting the ICA obviating correction for PVE. METHODS: The AUC of the ICA and sagittal sinus were measured in CTP datasets from 52 patients. The AUCs were determined by i) using commercial CTP software based on a Gaussian curve-fitting to the time attenuation curve, and ii) by simple integration of the time attenuation curve over a time interval. In addition, frames acquired up to 3 minutes after first bolus passage were used to examine the ratio of arterial and venous enhancement. The impact of selecting the ICA without PVE correction was illustrated by reporting cerebral blood volume (CBV) measurements. RESULTS: In 49 of 52 patients, the AUC of the ICA was significantly larger than that of the sagittal sinus (p = 0.017). Measured after the first pass bolus, contrast enhancement remained 50% higher in the ICA just after the first pass bolus, and 30% higher 3 minutes later. CBV measurements were significantly lowered when the ICA was used without PVE correction. CONCLUSIONS: Contradicting the assumptions underlying PVE correction, contrast in the ICA was significantly higher than in the sagittal sinus, even 3 minutes after the first pass of the contrast bolus. PVE correction might lead to overestimation of CBV if the CBV is calculated using the AUC of the time attenuation curves.


Assuntos
Volume Sanguíneo , Encéfalo/irrigação sanguínea , Artéria Carótida Interna/diagnóstico por imagem , Meios de Contraste , Cavidades Cranianas/diagnóstico por imagem , Imagem de Perfusão/métodos , Tomografia Computadorizada por Raios X/métodos , Área Sob a Curva , Encéfalo/diagnóstico por imagem , Artéria Carótida Interna/fisiologia , Cavidades Cranianas/fisiologia , Humanos , Estudos Retrospectivos
9.
Childs Nerv Syst ; 30(5): 831-4, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24526343

RESUMO

INTRODUCTION: The inferior petrosal sinus is an important component of the cerebral venous system with implications in diagnosis and treatment of a variety of diseases such as Cushing's disease, carotid cavernous, and dural arteriovenous fistulas. METHODS: This manuscript will review the anatomy, embryology, and clinical implications of the inferior petrosal sinus. CONCLUSIONS: Knowledge of the inferior petrosal sinus is of great importance for open surgical approaches to the skull base and endovascular access to the cavernous sinus and sellar region.


Assuntos
Fístula Carótido-Cavernosa/cirurgia , Malformações Vasculares do Sistema Nervoso Central/cirurgia , Cavidades Cranianas , Síndrome de Cushing/cirurgia , Cavidades Cranianas/citologia , Cavidades Cranianas/embriologia , Cavidades Cranianas/fisiologia , Cavidades Cranianas/cirurgia , Humanos
10.
J Appl Physiol (1985) ; 115(10): 1474-80, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24052030

RESUMO

The physiological effect of posture on intracranial pressure (ICP) is not well described. This study defined and evaluated three mathematical models describing the postural effects on ICP, designed to predict ICP at different head-up tilt angles from the supine ICP value. Model I was based on a hydrostatic indifference point for the cerebrospinal fluid (CSF) system, i.e., the existence of a point in the system where pressure is independent of body position. Models II and III were based on Davson's equation for CSF absorption, which relates ICP to venous pressure, and postulated that gravitational effects within the venous system are transferred to the CSF system. Model II assumed a fully communicating venous system, and model III assumed that collapse of the jugular veins at higher tilt angles creates two separate hydrostatic compartments. Evaluation of the models was based on ICP measurements at seven tilt angles (0-71°) in 27 normal pressure hydrocephalus patients. ICP decreased with tilt angle (ANOVA: P < 0.01). The reduction was well predicted by model III (ANOVA lack-of-fit: P = 0.65), which showed excellent fit against measured ICP. Neither model I nor II adequately described the reduction in ICP (ANOVA lack-of-fit: P < 0.01). Postural changes in ICP could not be predicted based on the currently accepted theory of a hydrostatic indifference point for the CSF system, but a new model combining Davson's equation for CSF absorption and hydrostatic gradients in a collapsible venous system performed well and can be useful in future research on gravity and CSF physiology.


Assuntos
Pressão Intracraniana , Veias Jugulares/fisiologia , Modelos Cardiovasculares , Postura , Absorção , Adaptação Fisiológica , Líquido Cefalorraquidiano/metabolismo , Cavidades Cranianas/fisiologia , Gravitação , Humanos , Pressão Hidrostática , Decúbito Dorsal , Pressão Venosa
11.
J Neurointerv Surg ; 5(5): 458-60, 2013 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-22942187

RESUMO

BACKGROUND: Cerebral venography and manometry are used for the diagnosis of hemodynamically significant venous sinus stenosis in patients with the syndrome of idiopathic intracranial hypertension. Intravenous pressure measurements using the traditional microcatheter technique can be cumbersome, time consuming and potentially unreliable. The PrimeWire Prestige pressure guidewire conducts pressure electrically and can be used as a guidewire for intervention. It has been validated in interventional cardiology procedures. OBJECTIVE: We describe our initial clinical experience with the PrimeWire Prestige pressure guidewire system for cerebral venous manometry and intervention. METHOD: Cerebral venous pressure gradient was directly measured by advancing the pressure wire across a region of stenosis. The pressure wire was also used as a guidewire for intravascular ultrasound, angioplasty and stenting. RESULTS: The PrimeWire Prestige pressure guidewire successfully navigated the intracranial venous sinus anatomy. Transfer of devices over the guidewire in a monorail fashion was uncomplicated, and measurement of sinus pressure between the steps of the intervention was efficiently performed. CONCLUSION: The PrimeWire Prestige pressure guidewire system provided a safe, fast and effective method for intracranial venous sinus manometry and intervention. It has several potential advantages over the traditional microcatheter method, including efficiency, accuracy and cost.


Assuntos
Cavidades Cranianas/fisiologia , Manometria/instrumentação , Manometria/métodos , Pseudotumor Cerebral/diagnóstico , Angiografia Cerebral , Cavidades Cranianas/diagnóstico por imagem , Cavidades Cranianas/cirurgia , Humanos , Procedimentos Neurocirúrgicos/métodos , Pseudotumor Cerebral/diagnóstico por imagem , Pseudotumor Cerebral/fisiopatologia , Ultrassonografia
12.
Neurol Res ; 33(10): 1072-82, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22196761

RESUMO

OBJECTIVE: The analysis of cerebrospinal fluid (CSF) pulse pressure waveform has been considered as a reliable method to investigate the intracranial system (ICS) dynamics. We have examined the morphological changes of the CSF pulse wave and of the sagittal sinus pressure (SSP) wave during a progressive increase in intracranial pressure (ICP) in order to investigate the ICS dynamics. METHODS: Four dogs were anesthetized. Blood pressure, ICP, and SSP were simultaneously recorded. Two vertical tubes were inserted inside one lateral ventricle, thus allowing the half-opening (one tube open) and opening (both tubes open) of the ICS. ICP was modified by varying the height of the liquid column into the tubes. Pressures were analyzed by applying the fast Fourier transformation on each pulse pressure wave. We distinguished two peaks (first and second peaks) and a notch in each pulse pressure wave. The pressure was raised from resting pressure up to 50 mmHg. RESULTS: A progressive and distinct change in the CSF pulse pressure shape was evident when opening the ICS to the atmosphere: a reduction in the height of the dicrotic notch and in the amplitude of the second peak and a corresponding positive shift of the first harmonic with respect to the onset of the CSF pulse pressure wave. DISCUSSION: A decrease in the amplitude of the CSF pulse waveform second peak and a positive phase shift of its first harmonic indicate an opening of the ICS to the atmosphere, i.e. an increase in the intracranial compliance.


Assuntos
Pressão Venosa Central/fisiologia , Pressão do Líquido Cefalorraquidiano/fisiologia , Pressão Intracraniana/fisiologia , Modelos Biológicos , Animais , Determinação da Pressão Arterial/métodos , Circulação Cerebrovascular/fisiologia , Cavidades Cranianas/fisiologia , Cães , Feminino , Análise de Fourier , Hemodinâmica/fisiologia , Hidrodinâmica , Masculino , Modelos Animais
13.
J Hum Evol ; 60(2): 234-9, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21183202

RESUMO

Many morphological features of the Pleistocene fossil hominin Homo neanderthalensis, including the reputed large size of its paranasal sinuses, have been interpreted as adaptations to extreme cold, as some Neanderthals lived in Europe during glacial periods. This interpretation of sinus evolution rests on two assumptions: that increased craniofacial pneumatization is an adaptation to lower ambient temperatures, and that Neanderthals have relatively large sinuses. Analysis of humans, other primates, and rodents, however, suggests that the first assumption is suspect; at least the maxillary sinus undergoes a significant reduction in volume in extreme cold, in both wild and laboratory conditions. The second assumption, that Neanderthal sinuses are large, extensive, or even 'hyperpneumatized,' has held sway since the first specimen was described and has been interpreted as the causal explanation for some of the distinctive aspects of Neanderthal facial form, but has never been evaluated with respect to scaling. To test the latter assumption, previously published measurements from two-dimensional (2D) X-rays and new three-dimensional (3D) data from computed tomography (CT) of Neanderthals and temperate-climate European Homo sapiens are regressed against cranial size to determine the relative size of their sinuses. The 2D data reveal a degree of craniofacial pneumatization in Neanderthals that is both commensurate with the size of the cranium and comparable in scale with that seen in temperate climate H. sapiens. The 3D analysis of CT data from a smaller sample supports this conclusion. These results suggest that the distinctive Neanderthal face cannot be interpreted as a direct result of increased pneumatization, nor is it likely to be an adaptation to resist cold stress; an alternative explanation is thus required.


Assuntos
Cavidades Cranianas/anatomia & histologia , Hominidae/anatomia & histologia , Hominidae/fisiologia , Adaptação Fisiológica , Animais , Temperatura Baixa , Cavidades Cranianas/fisiologia , Face , Humanos
14.
Neurosurg Clin N Am ; 20(3): 265-78, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19778699

RESUMO

Students of cerebrovascular anatomy and physiology tend to model their learning based on normal patterns of blood flow. As such, the focus tends toward arterial physiology and pathology with less than adequate understanding of the significance of the venous system. This article presents a different approach to neurovascular anatomy, starting with the venous system and demonstrating both normal and pathologic states. It reviews the cerebral circulation with attention to the microsurgical relationships, angiographic patterns, and fusion of dual-volume imaging. The importance of bony, sulcal, and ventricular anatomy is presented as it relates to the angiographic representation of pathologic lesions. Examples are given of anatomic variants seen with the operating microscope, biplanar angiography, and three-dimensional rotational angiography." Note that in the synopsis and throughout the article, first person usage has been changed to third person per journal style.


Assuntos
Encéfalo/irrigação sanguínea , Artéria Carótida Interna/anatomia & histologia , Artérias Cerebrais/anatomia & histologia , Artéria Vertebral/anatomia & histologia , Artéria Basilar/anatomia & histologia , Artéria Basilar/fisiologia , Artéria Carótida Interna/fisiologia , Angiografia Cerebral , Artérias Cerebrais/diagnóstico por imagem , Artérias Cerebrais/patologia , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/patologia , Círculo Arterial do Cérebro/anatomia & histologia , Círculo Arterial do Cérebro/fisiologia , Cavidades Cranianas/anatomia & histologia , Cavidades Cranianas/fisiologia , Humanos , Artéria Vertebral/fisiologia
15.
Acta Neurochir (Wien) ; 151(11): 1459-64, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19424657

RESUMO

OBJECTIVES: Surgery for parasagittal and falcine meningiomas requires meticulous preservation of the cortical veins that surround the tumour; thus, knowledge of the relevant venous anatomy would be extremely helpful during surgery. METHODS: This study utilises virtual reality technology to determine the number, size and disposition of the veins in relation to the tumour in 8 patients with parasagittal and falcine meningiomas. The same data were also collected from the scans of 8 normal subjects and compared with the data from the meningioma patients. RESULTS: Our results show that the average number of veins is comparable in the tumour and control groups, and that the number of veins on either side does not differ significantly for both groups. On measurement, the size of the veins is approximately the same on either side of the superior sagittal sinus for both the control and the tumour groups. It was also observed that regardless of size, most of the parasagittal and falcine meningiomas demonstrated no significant anatomical distortion effects on the adjacent venous structures, with the exception of one parasagittal meningioma with invasion of the superior sagittal sinus and concomitant engulfment of the draining veins. CONCLUSION: Data from a larger population would have to be collected in order to determine the effect of the growth of these tumours on the surrounding venous anatomy. With virtual reality technology, the parasagittal veins are clearly discerned, and knowing their location and relationship to the tumour would contribute towards safe and effective surgery.


Assuntos
Veias Cerebrais/anatomia & histologia , Imageamento Tridimensional/métodos , Angiografia por Ressonância Magnética/métodos , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Interface Usuário-Computador , Adulto , Idoso , Mapeamento Encefálico/métodos , Veias Cerebrais/fisiologia , Veias Cerebrais/cirurgia , Circulação Cerebrovascular/fisiologia , Cavidades Cranianas/anatomia & histologia , Cavidades Cranianas/fisiologia , Cavidades Cranianas/cirurgia , Dura-Máter/anatomia & histologia , Dura-Máter/cirurgia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Complicações Intraoperatórias/prevenção & controle , Imageamento por Ressonância Magnética/métodos , Masculino , Neoplasias Meníngeas/irrigação sanguínea , Neoplasias Meníngeas/cirurgia , Meningioma/irrigação sanguínea , Meningioma/cirurgia , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Adulto Jovem
16.
J Clin Neurosci ; 16(3): 421-4, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19144524

RESUMO

Surgery of the superior sagittal sinus (SSS) is a challenging areas for neurosurgeons. To better understand the anatomy of the SSS, we examined the chordae and arachnoid granulations in the lumen of the SSS and torcular herophili with the aid of an endoscope and a microscope, and re-evaluated the role of the chordae Willisii in preventing blood backflow. We prepared 10 SSS from fresh human cadavers during autopsies. After the cranial vaults were removed, an endoscope was inserted into the lumen of the sinus to examine the structures and morphological features of the chordae Willisii, and the topographic distribution of the arachnoid granulations. The sinuses were subsequently opened using standard anatomical methods and the intraluminal structures of the dural sinus were subjected to microanatomic analysis. In another five formalin-embalmed cadaver heads, blue latex was injected from the posterior end of the SSSs to observe filling of the SSS tributaries. We identified three types of chordae in the lumen of the SSS: valve-like chordae (48.3% of all chordae), followed by trabecular (31.5%) and laminar (20.2%) chordae. The laminar chordae at the posterior end of the SSS divide the sinus into two separate channels of different sizes. Similar structures were also seen in the lumen of the torcular herophili. The majority of arachnoid granulations were found as digitations in the lumen at the lateral wall or lateral recess of the middle segment of the SSS. Microscopic examination of the intraluminal structures of the SSS confirmed endoscopic findings. In the injection test we found that the SSS tributaries could be filled retrogradely with artificial dye, suggesting that the function of valve-like chordae in preventing the backflow of blood is restricted only to physiological conditions. Thus, we could visualize and examine endoscopically the intact intraluminal structures of the SSS, which may have therapeutic or diagnostic significance.


Assuntos
Cavidades Cranianas/anatomia & histologia , Endoscopia/métodos , Microscopia/métodos , Seio Sagital Superior/anatomia & histologia , Cadáver , Cavidades Cranianas/fisiologia , Humanos , Seio Sagital Superior/fisiologia , Seios Transversos/anatomia & histologia , Seios Transversos/fisiologia
17.
Clin Anat ; 21(4): 294-300, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18428995

RESUMO

The confluence of sinuses (CS; torcular herophili) is represented by the junction of the superior sagittal (SSS), straight (SS), occipital (OS), and two transverse sinuses (TS). The objective of this study was to interpret sinus flow around the CS by morphological investigation of the sinuses. This study is based on visual examination of dural venous sinuses in the region of the CS in 31 adult cadavers. In the inflow zone, we examined the direction of SSS and SS flow. In the communication zone, we examined the extent to which outflow sinuses communicate with other sinuses. In the outflow zone, we used the diameters of outflow sinuses to determine anatomical dominance. The SSS entered the CS via the right TS in 16 cases (51.6%) and via the center of the CS in 14 cases (45.2%). The SS entered via the center of the CS in 18 cases (58.1%) and via the left TS in 11 cases (35.5%). Outflow sinuses communicated freely in 26 cases (83.8%) and communicated partially in five cases (16.2%). Partial communication was the result of a septate CS. In terms of outflow, the right TS was dominant in 11 cases (35.5%), and in 18 cases (58.1%), outflow was symmetrical. The direction of SSS inflow was different from that of SS inflow, and partial communication was observed in five cases (16.1%). Therefore, the presence of a septum may be considered an anatomical factor, with implications in diagnosis or in the sacrifice of the outflow sinus of the CS.


Assuntos
Cavidades Cranianas/anatomia & histologia , Cavidades Cranianas/fisiologia , Cadáver , Humanos , Fluxo Sanguíneo Regional , Seio Sagital Superior/anatomia & histologia , Seio Sagital Superior/fisiologia , Seios Transversos/anatomia & histologia , Seios Transversos/fisiologia
18.
Folia Morphol (Warsz) ; 66(2): 115-9, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17594669

RESUMO

Intracranial physiological calcifications are unaccompanied by any evidence of disease and have no demonstrable pathological cause. They are often due to calcium and sometimes iron deposition in the blood vessels of different structures of the brain. Computed tomography (CT) is the most sensitive means of detection of these calcifications. The aim of this study was the assessment of intracranial physiological calcifications in adults. We studied 1569 cases ranging in age from 15 to 85 in Tabriz Imam Khomeini Hospital, Iran. These patients had a history of head trauma and their CT scan did not show any evidence of pathological findings. The structures evaluated consisted of (A) the pineal gland, (B) the choroid plexus, (C) the habenula, (D) the basal ganglia, (E) the tentorium cerebelli, sagittal sinus and falx cerebri, (F) vessels and (G) lens and other structures which could be calcified. Of the 1569 subjects, 71.0% had pineal calcification, 66.2% had choroid plexus calcification, 20.1% had habenular calcification, 7.3% had tentorium cerebelli, sagittal sinus or falx cerebri calcifications, 6.6% had vascular calcification, 0.8% had basal ganglia calcification and 0.9% had lens and other non-defined calcifications. In general, the frequency of intracranial physiological calcifications was greater in men than in women. All types of calcification increased at older ages except for lens and other non-defined calcifications. We evaluated all the cranial structures and determined percentages for all types of intracranial physiological calcification. These statistics can be used for comparing physiological and pathological intracranial calcifications. Moreover, these statistics may be of interest from the clinical perspective and are potentially of clinical use.


Assuntos
Encéfalo/diagnóstico por imagem , Artérias Cerebrais/diagnóstico por imagem , Cavidades Cranianas/diagnóstico por imagem , Dura-Máter/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Gânglios da Base/anatomia & histologia , Gânglios da Base/diagnóstico por imagem , Gânglios da Base/fisiologia , Encéfalo/anatomia & histologia , Encéfalo/fisiologia , Calcificação Fisiológica/fisiologia , Artérias Cerebrais/anatomia & histologia , Artérias Cerebrais/fisiologia , Plexo Corióideo/anatomia & histologia , Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/fisiologia , Cavidades Cranianas/anatomia & histologia , Cavidades Cranianas/fisiologia , Traumatismos Craniocerebrais/patologia , Traumatismos Craniocerebrais/fisiopatologia , Dura-Máter/anatomia & histologia , Dura-Máter/fisiologia , Feminino , Habenula/anatomia & histologia , Habenula/diagnóstico por imagem , Habenula/fisiologia , Humanos , Irã (Geográfico) , Cristalino/anatomia & histologia , Cristalino/diagnóstico por imagem , Cristalino/fisiologia , Masculino , Pessoa de Meia-Idade , Glândula Pineal/anatomia & histologia , Glândula Pineal/diagnóstico por imagem , Glândula Pineal/fisiologia , Caracteres Sexuais
19.
AJNR Am J Neuroradiol ; 28(5): 983-9, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17494684

RESUMO

BACKGROUND AND PURPOSE: We have previously reported a model of cerebral hydrodynamics in the form of an equivalent electrical circuit. The aim of this work was to demonstrate that the model could predict venous flow patterns seen in the superior sagittal sinus (SSS), straight sinus (STS), and jugular vein (JV) in normal volunteers. MATERIALS AND METHODS: An electrical equivalence model of CSF and cerebral blood flow was fitted to measured arterial and CSF data from 16 healthy volunteers. Predictions of the venous outflow waveform derived from the model were compared with measured venous flows in the SSS, STS, and JV. RESULTS: The model accurately predicted the measured jugular waveform. The measured waveforms from SSS and STS showed a less pronounced and delayed systolic peak compared with the predicted outflow. The fitted bulk model parameters provided relative values that correspond approximately to the impedance of arterial capillaries (1.0), cerebral aqueduct ( approximately 0), venous capillaries ( approximately 0), and arteries (0.01) and for the elastic capacitance of the ventricles (4.11), capillaries ( approximately 0), and veins (271). The elastic capacitance of the major cerebral arteries was large and could not be accurately determined. CONCLUSIONS: We have confirmed the ability of the model to predict the venous waveforms in healthy persons. The absence of any statistically significant component of the venous waveform not described by the model implies that measurements of venous flow could be used to constrain further the model-fitting process.


Assuntos
Ventrículos Cerebrais/fisiologia , Líquido Cefalorraquidiano/fisiologia , Circulação Cerebrovascular/fisiologia , Veias Jugulares/fisiologia , Modelos Cardiovasculares , Adulto , Cavidades Cranianas/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Valor Preditivo dos Testes , Fluxo Pulsátil/fisiologia , Sístole
20.
J Morphol ; 268(3): 243-53, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17278134

RESUMO

The frontal sinuses of bovid mammals display a great deal of diversity, which has been attributed to both phylogenetic and functional influences. In-depth study of the hartebeest (Alcelaphus buselaphus), a large African antelope, reveals a number of previously undescribed details of frontal sinus morphology. In A. buselaphus, the frontal sinuses conform closely to the shape of the frontal bone, filling nearly the entire element. However, the horncores are never extensively pneumatized, contrasting with the condition seen in many other bovids. This evidence is inconsistent with the hypothesis that sinuses are opportunistic pneumatizing agents, suggesting that phylogenetic factors also play a role in determining sinus size. Both cranial sutures and neurovasculature appear to constrain the growth of sinuses in part. In turn, the sinus also affects the growth of the parietal; apparently this element is not truly pneumatized by the sinus in most cases, but the bone's shape changes under the influence of the sinus. Furthermore, the sinuses present relatively few struts when compared with the sinuses of some other bovids, such as Ovis. By adapting methods previously developed for measuring structural parameters of trabecular bone, it is possible to quantify certain aspects of sinus morphology. These include the number of bony struts within the sinus, the spacing of these struts, and the size of individual cavities within the sinus. Some differences in the number of struts are evident between subspecies. Similarly, significant differences occur in the relative number of struts between male and female A. buselaphus, which may be related to behavior. The volume of the sinus is strongly correlated with the size of the frontal, but less so with overall cranial size. This finding illustrates the importance of choosing variables carefully when comparing sinus sizes and growth between species.


Assuntos
Antílopes/anatomia & histologia , Cavidades Cranianas/anatomia & histologia , Caracteres Sexuais , Animais , Antílopes/fisiologia , Comportamento Animal/fisiologia , Cavidades Cranianas/fisiologia , Feminino , Masculino
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