Arachnoid Membranes: Crawling Back into Radiologic Consciousness

Lu, Shisheng; Brusic, Ana; Gaillard, Frank

doi:10.3174/ajnr.a7309

Cited by 9 publications

(5 citation statements)

References 46 publications

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“…The trans-ventricular CWW10 was bordered by the foramina of Monro and Magendie, and was further demarcated by fine parenchymal structures such as the lamina terminalis (separating the third ventricle from the lamina terminalis cistern [CWW5]). In some other instances, the interfaces between basilar cistern CWWs aligned with the arachnoid membranes (3,30). The interface separating the chiasmatic cistern (CWW4) and prepontine cisterns (CWW5) approximated the sellar segment of the Liliequist membrane.…”

Section: Discussionmentioning

confidence: 97%

The Spatial Patterns and Determinants of Cerebrospinal Fluid Circulation in the Human Brain

Nazeri,

Dehkharghanian,

Lindsay

et al. 2023

Preprint

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The circulation of cerebrospinal fluid (CSF) is essential for maintaining brain homeostasis and clearance, and impairments in its flow can lead to various brain disorders. Recent studies have shown that CSF circulation can be interrogated using low b-value diffusion magnetic resonance imaging (low-b dMRI). Nevertheless, the spatial organization of intracranial CSF flow dynamics remains largely elusive. Here, we developed a whole-brain voxel-based analysis framework, termed CSF pseudo-diffusion spatial statistics (CΨSS), to examine CSF mean pseudo-diffusivity (MΨ), a measure of CSF flow magnitude derived from low-b dMRI. We showed that intracranial CSF MΨ demonstrates characteristic covariance patterns by employing seed-based correlation analysis. Importantly, we applied non-negative matrix factorization analysis to further elucidate the covariance patterns of CSF MΨ in a hypothesis-free, data-driven way. We identified distinct CSF spaces that consistently displayed unique pseudo-diffusion characteristics across multiple imaging datasets. Our study revealed that age, sex, brain atrophy, ventricular anatomy, and cerebral perfusion differentially influence MΨ across these CSF spaces. Notably, individuals with anomalous CSF flow patterns displayed incidental findings on multimodal neuroradiological examinations. Our work sets forth a new paradigm to study CSF flow, with potential applications in clinical settings.

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Section: Discussionmentioning

confidence: 97%

The Spatial Patterns and Determinants of Cerebrospinal Fluid Circulation in the Human Brain

Nazeri,

Dehkharghanian,

Lindsay

et al. 2023

Preprint

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show abstract

“…To the best of our knowledge, there are no previous descriptions of how a compartmentalized, perivascular subarachnoid space affects CSF flow in humans. Previous studies on the arachnoid mater have primarily addressed the anatomical organization of arachnoid trabeculations and membranes 9 , 18 . For decades, the arachnoid anatomy has attracted the interest of neurosurgeons; Yassargil 19 introduced the technique of moving micro-surgically from one arachnoid cistern to another, using these as surgical landmarks.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, a fourth meningeal layer, known as the subarachnoid lymphatic-like membrane (SLYM), was described in rodents 8 , and proposed to segregate the subarachnoid space into an outer and inner layer. Also human studies have focused on the anatomic organization of the subarachnoid space, which is further known to consist of arachnoid trabeculae and membranes, creating distinct regions or cisterns within the space 9 . However, the impact on cerebrospinal fluid (CSF) flow exerted by these anatomical boundaries remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Functional analysis of the human perivascular subarachnoid space

Eide,

Ringstad

2024

Nat Commun

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The human subarachnoid space harbors the cerebrospinal fluid, which flows within a landscape of blood vessels and trabeculae. Functional implications of subarachnoid space anatomy remain far less understood. This study of 75 patients utilizes a cerebrospinal fluid tracer (gadobutrol) and consecutive magnetic resonance imaging to investigate features of early (i.e. within 2-3 h after injection) tracer propagation within the subarachnoid space. There is a time-dependent perivascular pattern of enrichment antegrade along the major cerebral artery trunks; the anterior-, middle-, and posterior cerebral arteries. The correlation between time of first enrichment around arteries and early enrichment in nearby cerebral cortex is significant. These observations suggest the existence of a compartmentalized subarachnoid space, where perivascular ensheathment of arteries facilitates antegrade tracer passage towards brain tissue. Periarterial transport is impaired in subjects with reduced intracranial pressure-volume reserve capacity and in idiopathic normal pressure hydrocephalus patients who also show increased perivascular space size.

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“…He provided evidence for the presence of the arachnoid membrane as a separate meningeal layer and detailed how this membrane enveloped different cerebral vessels and intracranial nerves. 1,2 Until recently it was accepted that the subarachnoid space represented a continuous space filled with cerebrospinal fluid (CSF) 3,4 . However, a recent publication authored by Mollgard et al has revealed the existence of a mesothelial layer that partitions the subarachnoid space into two distinct compartments.…”

Section: Introductionmentioning

confidence: 99%

Assessing the subarachnoid space anatomy on clinical imaging: utilizing normal and pathology to understand compartmentalization of the subarachnoid space

Almohaimede,

Alibrahim,

Butt

et al. 2024

Preprint

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BACKGROUND: The goal of the study is to use CT imaging in patients with aSAH to evaluate the anatomic distribution of hemorrhage and compartmentalization of subarachnoid space to investigate potential in vivo visualization of recently discovered layer named subarachnoid lymphatic like membrane (SLYM). METHODS: We conducted a retrospective cohort study of cases with aneurysmal SAH (aSAH) at our institution between January 2015 and June 2022. Subarachnoid hemorrhage distribution into superficial and deep subarachnoid spaces was classified based on proximity to the dural or pial surfaces, respectively, as seen on multiplanar CT head. RESULTS: A total of 97 patients with aSAH were included. Patients with lower modified Fisher score (MFS) of 1-2 were more likely to have SAH compartmentalizing in the (deep) pial-adjacent subarachnoid space. Patients with higher MFS of 3-4 were more likely to have SAH in both (superficial) and (deep) compartments along the brainstem. There is a significant association between the severity of aSAH - quantified by the MFS - and the distribution of the blood. Patients with higher MFS scores were roughly 7.6 times (p-value = 0.049) more likely to have hemorrhage at the (Superficial) juxta-dural subarachnoid compartment when compared to those with lower MFS scores. CONCLUSION: This study suggests an imaging correlate to the recently discovered SLYM, potentially influencing aSAH compartmentalization, particularly in low-grade bleeds. While compartmentalization is limited in high-grade cases, these findings warrant further investigation with advanced imaging techniques to validate this membrane's role and potential impact on CSF flow and aSAH pathophysiology.

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Arachnoid Membranes: Crawling Back into Radiologic Consciousness

Cited by 9 publications

References 46 publications

The Spatial Patterns and Determinants of Cerebrospinal Fluid Circulation in the Human Brain

The Spatial Patterns and Determinants of Cerebrospinal Fluid Circulation in the Human Brain

Functional analysis of the human perivascular subarachnoid space

Assessing the subarachnoid space anatomy on clinical imaging: utilizing normal and pathology to understand compartmentalization of the subarachnoid space

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