S Tsutsumi1, I Ogino2, M Miyajima2, M Nakamura3, Y Yasumoto4, H Arai2, M Ito4. 1. From the Department of Neurological Surgery (S.T., Y.Y., M.I.), Juntendo University Urayasu Hospital, Chiba, Japan shotaro@juntendo-urayasu.jp. 2. Department of Neurological Surgery (I.O., M.M., H.A.), Juntendo University School of Medicine, Tokyo, Japan. 3. Division of Radiological Technology (M.N.), Medical Satellite Yaesu Clinic, Tokyo, Japan. 4. From the Department of Neurological Surgery (S.T., Y.Y., M.I.), Juntendo University Urayasu Hospital, Chiba, Japan.
Abstract
BACKGROUND AND PURPOSE: Studies have suggested that arachnoid villi or granulations found in the walls of the cranial dural sinuses, olfactory mucosa, and cranial nerve sheaths function as outlets for intracranial CSF. However, their role as CSF outlets has not yet been verified. Here we show that arachnoid protrusions and contiguous diploic veins provide an alternative drainage route for intracranial CSF. MATERIALS AND METHODS: Four hundred patients with intact skull, dura mater, and dural sinuses underwent MR imaging to explore arachnoids protruding into the skull and diploic veins. Patients with symptoms of increased intracranial pressure or intracranial hypotension were excluded. For 15 patients undergoing craniotomy, both peripheral and diploic venous blood was collected. Albumin and the CSF-specific biomarkers were measured by enzyme-linked immunosorbent assay. RESULTS: With MR imaging, arachnoid protrusions into the skull and contiguous diploic veins were consistently identified throughout the cranium with their characteristic appearance depending on the cranial region. In addition, elevated amounts of prostaglandin D synthase and cystatin C were confirmed in diploic veins compared with peripheral venous blood. CONCLUSIONS: Diploic veins are distributed ubiquitously throughout the cranium. A portion of the intracranial CSF may be drained through arachnoid protrusions and contiguous diploic veins.
BACKGROUND AND PURPOSE: Studies have suggested that arachnoid villi or granulations found in the walls of the cranial dural sinuses, olfactory mucosa, and cranial nerve sheaths function as outlets for intracranial CSF. However, their role as CSF outlets has not yet been verified. Here we show that arachnoid protrusions and contiguous diploic veins provide an alternative drainage route for intracranial CSF. MATERIALS AND METHODS: Four hundred patients with intact skull, dura mater, and dural sinuses underwent MR imaging to explore arachnoids protruding into the skull and diploic veins. Patients with symptoms of increased intracranial pressure or intracranial hypotension were excluded. For 15 patients undergoing craniotomy, both peripheral and diploic venous blood was collected. Albumin and the CSF-specific biomarkers were measured by enzyme-linked immunosorbent assay. RESULTS: With MR imaging, arachnoid protrusions into the skull and contiguous diploic veins were consistently identified throughout the cranium with their characteristic appearance depending on the cranial region. In addition, elevated amounts of prostaglandin D synthase and cystatin C were confirmed in diploic veins compared with peripheral venous blood. CONCLUSIONS: Diploic veins are distributed ubiquitously throughout the cranium. A portion of the intracranial CSF may be drained through arachnoid protrusions and contiguous diploic veins.
Authors: T Yamashima; K Sakuda; Y Tohma; J Yamashita; H Oda; D Irikura; N Eguchi; C T Beuckmann; Y Kanaoka; Y Urade; O Hayaishi Journal: J Neurosci Date: 1997-04-01 Impact factor: 6.167
Authors: Abdullah Alarfaj; Tejas Sankar; Ravi Bhargava; Jonathan Tyler; Anil Walji; Richard Fox; Aziz Sagga; Abdullah Ishaque; Keith Aronyk Journal: Surg Neurol Int Date: 2021-05-31