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J Anat 2022 04 23;240(4):724-734. Epub 2021 Nov 23.

Postgraduate Program in Biology applied to Health (PPGBAS), Keizo Asami Immunopathology Laboratory (LIKA), Federal University of Pernambuco (UFPE), Recife, Brazil.

Mast cells, known as pro-inflammatory effector cells, are immunocytes present in the meninges and may be involved in the pathophysiology of migraine. This study aims to evaluate the histomorphometric parameters of mast cells located in the convexity of the human intracranial dura mater. For this, samples of intracranial dura mater from eight human fresh cadavers were collected between 8- and 24-h post-mortem. Read More

J Cereb Blood Flow Metab 2022 01 2;42(1):162-174. Epub 2021 Sep 2.

Department of Brain Ischemia and Neurodegeneration, Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain; Area of Neurosciences, IDIBAPS, Barcelona, Spain.

Growing evidence indicates that perivascular tissue is critical to modulate vessel function. We hypothesized that the arachnoid membrane surrounding middle cerebral artery (MCA) regulates its function via sphingosine-1-phosphate (S1P)-induced vasoconstriction. The MCA from 3- to 9-month-old male and female wild-type (Oncine France 1 and C57BL/6) mice and sphingosine kinase 2 knockout (SphK2-/-) mice in the C57BL/6 background was mounted in pressure myographs with and without arachnoid membrane. Read More

Acta Biomed 2021 08 26;92(S4):e2021412. Epub 2021 Aug 26.

Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy..

Introduction Treatment of cranial neurovascular pathology requires a detailed understanding of the brain, head, and neck vasculature. This study aims at a comprehensive overview of the microsurgical anatomy of the anterior cerebral circulation. Methods Five formalin-fixed adult cadaveric heads were used. Read More

Rev Neurol (Paris) 2021 Sep 9;177(7):765-772. Epub 2021 Aug 9.

Department of Neurosurgery, CHU de Nice, Université Cote d'Azur, Nice, France; Université Cote d'Azur, FHU INOVPAIN, CHU de Nice, Nice, France.

Understanding intracranial nociceptive innervation is essential to understand the pathophysiology of headaches. Our knowledge about human intracranial nociception comes from sparse observations during neurosurgical procedures performed in awake patients, from human anatomical studies and from experimental studies in animals. In this article we review the anatomical and functional organization underlying nociceptive innervation. Read More

J Neurosurg 2022 01 23;136(1):257-263. Epub 2021 Jul 23.

3Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea.

Objective: The optic nerve sheath diameter (ONSD) excluding the dura mater (ONSDE; i.e., the subarachnoid diameter) and the ONSD including the dura mater (ONSDI) have been used differently in studies, but the predictive ability of these two different measurements of the ONSD as measured by invasive intracranial pressure (ICP) monitoring has never been compared. Read More

Biomech Model Mechanobiol 2021 Oct 17;20(5):1751-1766. Epub 2021 Jul 17.

Neuroscience Research Australia and Prince of Wales Clinical School, UNSW, Kensington, Australia.

Circulation of fluid through the central nervous system maintains fluid homeostasis and is involved in solute clearance. The glymphatic system is hypothesised to facilitate waste clearance in the brain, with inflow via periarterial spaces, bulk flow through the parenchyma, and outflow via perivenous spaces. The driving force for this mechanism is unknown. Read More

Circ Res 2021 06 24;129(1):174-194. Epub 2021 Jun 24.

Center for Brain Immunology and Glia (J.R., J.K.), Washington University in St. Louis, St Louis, MO.

Appropriate vascular function is essential for the maintenance of central nervous system homeostasis and is achieved through virtue of the blood-brain barrier; a specialized structure consisting of endothelial, mural, and astrocytic interactions. While appropriate blood-brain barrier function is typically achieved, the central nervous system vasculature is not infallible and cerebrovascular anomalies, a collective terminology for diverse vascular lesions, are present in meningeal and cerebral vasculature supplying and draining the brain. These conditions, including aneurysmal formation and rupture, arteriovenous malformations, dural arteriovenous fistulas, and cerebral cavernous malformations, and their associated neurological sequelae, are typically managed with neurosurgical or pharmacological approaches. Read More

Ann Palliat Med 2021 Jul 15;10(7):8371-8377. Epub 2021 Apr 15.

Department of Neurology, Peking University First Hospital, Beijing, China.

There are many causes of bilateral thalamic lesions, but few cases of dural arteriovenous fistula (DAVF) associated with such lesions have been reported previously. Here, we describe an adult man with reversible rapid progressive dementia (RPD) in whom bilateral thalamic lesions were caused by a DAVF that had six supply arteries and drained into both the venous sinus and cortical veins. A 53-year-old man presented with memory decline and abnormal behavior. Read More

J Stroke Cerebrovasc Dis 2021 Jul 17;30(7):105798. Epub 2021 Apr 17.

Department of Neuroradiology, AUSL Romagna, M. Bufalini Hospital, Cesena, Italy. Electronic address:

A 71-year-old man, with a pial micro-arteriovenous malformation (pAVM) draining into the confluence of the vein of Trolard and the vein of Labbé was surgically removed, sparing these cortical veins. 4-months MR and angiographic controls showed a de novo dural arteriovenous fistula (dAVF) draining into the previously spared cortical veins. It was removed using intraoperative motor evoked potentials (MEP). Read More

J Neurointerv Surg 2021 May 25;13(5):471-477. Epub 2021 Feb 25.

Radiology, Neurosurgery, NYU School of Medicine, New York, New York, USA.

Adoption of middle meningeal artery embolization in the management of chronic subdural hematomas has led to a renewed interest in dural vascular anatomy. The readily identifiable major dural arteries and potential hazards associated with their embolization are well described. Less emphasized are several levels of intrinsic dural angioarchitecture, despite their more direct relationship to dural based diseases, such as subdural hematoma and dural fistula. Read More

J Anat 2021 07 18;239(1):1-11. Epub 2021 Feb 18.

UMR 1253, ibrain, Université de Tours, Inserm, Tours, France.

Supratentorial sensory perception, including pain, is subserved by the trigeminal nerve, in particular, by the branches of its ophthalmic division, which provide an extensive innervation of the dura mater and of the major brain blood vessels. In addition, contrary to previous assumptions, studies on awake patients during surgery have demonstrated that the mechanical stimulation of the pia mater and small cerebral vessels can also produce pain. The trigeminovascular system, located at the interface between the nervous and vascular systems, is therefore perfectly positioned to detect sensory inputs and influence blood flow regulation. Read More

Proc Natl Acad Sci U S A 2021 01;118(3)

Human Brain Tissue Bank, Semmelweis University, H-1094 Budapest, Hungary.

Almost 150 papers about brain lymphatics have been published in the last 150 years. Recently, the information in these papers has been synthesized into a picture of central nervous system (CNS) "glymphatics," but the fine structure of lymphatic elements in the human brain based on imaging specific markers of lymphatic endothelium has not been described. We used LYVE1 and PDPN antibodies to visualize lymphatic marker-positive cells (LMPCs) in postmortem human brain samples, meninges, cavernous sinus (cavum trigeminale), and cranial nerves and bolstered our findings with a VEGFR3 antibody. Read More

Biomed Eng Online 2021 Jan 14;20(1):11. Epub 2021 Jan 14.

Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, FCMR-TT, 504 Scott Street, Fort Detrick, MD, 21702-5012, USA.

Background: Multiple studies describing human head finite element (FE) models have established the importance of including the major cerebral vasculature to improve the accuracy of the model predictions. However, a more detailed network of cerebral vasculature, including the major veins and arteries as well as their branch vessels, can further enhance the model-predicted biomechanical responses and help identify correlates to observed blunt-induced brain injury.

Methods: We used an anatomically accurate three-dimensional geometry of a 50th percentile U. Read More

J Stroke Cerebrovasc Dis 2021 Feb 8;30(2):105522. Epub 2020 Dec 8.

Stroke Center, Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Idaidori 2-1-1, Yahaba, Shiwa, Iwate, 028-3695, Japan.

A 50-year-old woman with a history of synovitis-acne-pustulosis-hyperostosis osteomyelitis (SAPHO) syndrome was admitted for left unilateral neglect, dysarthria, and left hemiparesis. Brain MRI showed multiple infarctions in the territory of the right middle cerebral artery and gadolinium enhancement of the thickened frontotemporal dura mater on the right side. MR angiography showed significant narrowing of the cavernous segment of the right internal carotid artery. Read More

Pain 2021 04;162(4):1153-1162

Institute of Physiology and Pathophysiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.

Abstract: The mechanisms underlying headaches attributed to hypoxia are poorly known. The activation of spinal trigeminal neurons with meningeal afferent input is believed to be responsible for the generation of headaches. In the caudal spinal trigeminal nucleus of anaesthetized and ventilated rats, the spontaneous firing of neurons with input from the exposed parietal dura mater and the activity evoked by mechanical stimuli to the dura and the adjacent periosteum were recorded, whereas the O2 fraction of the ventilation gas was stepwise reduced by omitting O2 and adding nitrogen. Read More

BMC Neurol 2020 Oct 6;20(1):366. Epub 2020 Oct 6.

Diagnostic & Interventional Neuroradiology, Department of Neuroradiology, Cannizzaro Hospital, Via Messina, 95126, Catania, Sicily, Italy.

Background: Sturge-Weber syndrome (SWS) is primarily diagnosed in pediatric population, but clinical presentation in late adulthood is rarely reported. Evolution of radiological findings in the adulthood variant of SWS with isolated leptomeningeal angiomatosis has never been reported to our knowledge.

Case Presentation: We report here a case of an isolated temporo-parieto-occipital leptomeningeal angiomatosis on the right cerebral hemisphere in a sixty-two-year-old male who presented with generalized seizure, GCS score 14/15 (E4 V4 M6) with equal and reacting pupils, psychomotor slowing, left hemineglect and grade 4 power in the left upper and lower limbs. Read More

Fluids Barriers CNS 2020 Aug 20;17(1):52. Epub 2020 Aug 20.

Center for Neural Engineering, The Pennsylvania State University, University Park, PA, USA.

The brain lacks a conventional lymphatic system to remove metabolic waste. It has been proposed that directional fluid movement through the arteriolar paravascular space (PVS) promotes metabolite clearance. We performed simulations to examine if arteriolar pulsations and dilations can drive directional CSF flow in the PVS and found that arteriolar wall movements do not drive directional CSF flow. Read More

J Stroke Cerebrovasc Dis 2020 Sep 2;29(9):105081. Epub 2020 Jul 2.

Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Iwate, Japan.

Background: Cerebrovascular reactivity (CVR) to acetazolamide (ACZ) on single-photon emission computed tomography (SPECT) can be used to assess the severity of chronic cerebral ischemia; however, this is an invasive method. We examined whether whole-brain magnetic resonance angiography (MRA) at 7T could non-invasively detect impaired CVR in patients with chronic cerebral ischemia by demonstrating the leptomeningeal collaterals (LMCs).

Methods: Fifty-seven patients with symptomatic unilateral cervical stenosis underwent whole-brain time-of-flight MRA at 7T and cerebral perfusion SPECT before/after the ACZ challenge. Read More

World Neurosurg 2020 10 19;142:131-135. Epub 2020 Jun 19.

Department of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. Electronic address:

Background: Dural arteriovenous fistulas (dAVFs) can often be successfully treated with endovascular embolization; however, surgery is occasionally still required.

Case Description: Herein, we discuss a 65-year-old male patient who presented with a Hunt-Hess IV subarachnoid hemorrhage, intraventricular hemorrhage, and cerebellar intracranial hemorrhage secondary to a ruptured Borden type III tentorial (straight sinus) dAVF. Angiography revealed supply from the left occipital and posterior meningeal arteries and direct drainage into the cerebellar cortical veins with venous aneurysms in both cerebellar hemispheres. Read More

World Neurosurg 2020 06 3;138:436-439. Epub 2020 Apr 3.

Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.

Background: Virchow-Robin or enlarged perivascular spaces (PVS) are benign pial-lined spaces that surround penetrating arteries and arterioles through the brain parenchyma. We present 2 cases of enlarging PVS in adults following whole-brain radiation therapy.

Case Description: Two patients underwent whole-brain radiation therapy for adult-onset medulloblastoma. Read More

World Neurosurg 2020 06 26;138:e847-e858. Epub 2020 Mar 26.

Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.

Background: Areas of contrast accumulation (CA) are commonly found on routine computed tomography (CT) performed immediately after thrombectomy. In the present study, we investigated the types of CA associated with the different outcomes, including symptomatic intracranial hemorrhage (sICH).

Methods: The present study analyzed the data from 145 patients with anterior circulation stroke who had undergone non-contrast-enhanced conventional CT immediately after thrombectomy. Read More

J Pak Med Assoc 2020 Feb;70(2):368-370

Aga Khan University Hospital, Karachi, Pakistan.

Pituitary adenomas are common, benign tumours, that can be classified in many ways including their functionality, size and anatomical extension. Historically, larger more invasive adenomas with extension into parasellar regions were deemd untreatable. However, with increasing operative sophistication, and more precise and effective radiation options; it is no longer the case, and therefore it becomes even more important for a comprehensive classification system for these tumours. Read More

World Neurosurg 2020 05 11;137:415. Epub 2020 Feb 11.

Department of Neurosurgery, Aviation General Hospital of China Medical University, Beijing, China. Electronic address:

Trigeminal neuralgia is featured by episodic and severe unilateral facial pain triggered usually by innocuous cutaneous stimuli. Microvascular decompression (MVD) is a safe and effective treatment for cases refractory to medical treatment caused by neurovascular conflicts. This Video 1 demonstrates MVD using arachnoid membrane and petrosal dura to transpose dual offending arteries. Read More

J Clin Neurosci 2020 Apr 14;74:253-255. Epub 2020 Jan 14.

Department of Evaluation and Treatment of Pain, FHU INOVPAIN, la Timone Hospital, AP-HM, Marseille, France; INSERM U-1107, CHU de Clermont-Ferrand, France.

Spontaneous intracranial hypotension (SIH) is a rare syndrome, typically manifests as orthostatic headache. Sometimes considered asbenignillness, neurological complications are well described, in particular subdural hematoma and cerebral venous sinus thrombosis. Brain infarction as complication of SIH is rarely reported. Read More

CNS Neurosci Ther 2020 01 13;26(1):14-20. Epub 2019 Apr 13.

Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital, The 307th Hospital of the Chinese People's Liberation Army, Academy of Military Medical Science, Beijing, China.

Aim: Previous studies have found significant differences in clinical characteristics between pediatric and adult moyamoya disease (MMD) patients, but few studies have focused on the factors underlying these differences. We aimed to investigate the differences in leptomeningeal collateral (LMC) status between pediatric and adult MMD patients and to analyze the effects of LMCs on clinical characteristics and therapeutic prognosis.

Methods: We retrospectively analyzed 214 MMD patients from January 2014 to January 2016. Read More

Forensic Sci Int 2020 Jan 16;306:110066. Epub 2019 Nov 16.

Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy. Electronic address:

In forensic evaluation of charred corpses, internal detrimental signs may result as more significant of those observed during external examination and is often arduous to state if a victim was exposed to fire before or after death. When the histological analysis of the remaining internal viscera is necessary, the massive destruction caused by the lesion, the charring and the coarctation of the samples don't allow to give further information or to determine the remaining organic components of the viscera. This limit is determined by the intrinsic characteristics of this thermal lesivity of self-maintenance even after the exitus of the subject, worsening the initial detrimental framework. Read More

Cephalalgia 2020 03 21;40(3):317-320. Epub 2019 Oct 21.

Department of Pathology, Spectrum Health, Grand Rapids, Michigan, USA.

Background: The middle meningeal artery is surrounded by a plexus of afferent fibers shown to be involved in the progression of some forms of headache, especially migraine. Posttraumatic headache disorders sharing characteristics with migraine and involving the middle meningeal artery are not readily available in the literature.

Case Description: This report describes a posttraumatic headache disorder in a middle-aged woman in which the causative factor proved to be a pathology of the left middle meningeal artery that resulted from trauma. Read More

World Neurosurg 2020 Jan 16;133:256-259. Epub 2019 Oct 16.

Department of Neurosurgery and Neuroendovascular Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.

Background: Endovascular embolization of the middle meningeal artery (MMA) is effective for recurrent chronic subdural hematoma (CSDH). CSDH associated with dural metastasis is generally refractory to burr hole surgery and has poor prognosis even if any interventions are applied. To the best of our knowledge, this study is the first to report a case of refractory CSDH associated with dural metastasis that was successfully treated with embolization of the MMA. Read More

JCI Insight 2019 10 17;4(20). Epub 2019 Oct 17.

Biogen, Cambridge, Masschusetts, USA.

Intrathecal (IT) delivery and pharmacology of antisense oligonucleotides (ASOs) for the CNS have been successfully developed to treat spinal muscular atrophy. However, ASO pharmacokinetic (PK) and pharmacodynamic (PD) properties remain poorly understood in the IT compartment. We applied multimodal imaging techniques to elucidate the IT PK and PD of unlabeled, radioactively labeled, or fluorescently labeled ASOs targeting ubiquitously expressed or neuron-specific RNAs. Read More