Skull Base Dural Thickness and Relationship to Demographic Features: A Postmortem Study and Literature Review

Fam, Maged D; Potash, Andrea E.; Potash, Martin; Robinson, Robert A.; O’Brien, Erin; Greenlee, Jeremy D.W.

doi:10.1055/s-0038-1651501

Cited by 19 publications

(8 citation statements)

References 21 publications

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“…However, the implication of folding of the TMF in duraplasty on the other abovementioned biomechanical parameters then also has to be explored in depth. The thickness of the TMF samples observed in this study of 1.46 ± 0.41 mm was larger compared with the site-dependent dura thicknesses of 0.36 ± 0.16 mm (petrous apex) 29 , 0.68 ± 0.20 mm (temporal dura presented in this study as a subgroup of recent investigations 21 ), 0.91 ± 1.14 (unspecified area) 13 or 1.11 ± 0.24 mm (craniocervical junction) 30 . However, it has to be noted that the evaluation of dura mater thickness by other research groups has partly been performed on embalmed tissue 13 , likewise introducing a significant bias.…”

Section: Discussioncontrasting

confidence: 64%

Biomechanical characterization of human temporal muscle fascia in uniaxial tensile tests for graft purposes in duraplasty

Zwirner

Ondruschka

Scholze

et al. 2021

Sci Rep

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The human temporal muscle fascia (TMF) is used frequently as a graft material for duraplasty. Encompassing biomechanical analyses of TMF are lacking, impeding a well-grounded biomechanical comparison of the TMF to other graft materials used for duraplasty, including the dura mater itself. In this study, we investigated the biomechanical properties of 74 human TMF samples in comparison to an age-matched group of dura mater samples. The TMF showed an elastic modulus of 36 ± 19 MPa, an ultimate tensile strength of 3.6 ± 1.7 MPa, a maximum force of 16 ± 8 N, a maximum strain of 13 ± 4% and a strain at failure of 17 ± 6%. Post-mortem interval correlated weakly with elastic modulus (r = 0.255, p = 0.048) and the strain at failure (r = − 0.306, p = 0.022) for TMF. The age of the donors did not reveal significant correlations to the TMF mechanical parameters. Compared to the dura mater, the here investigated TMF showed a significantly lower elastic modulus and ultimate tensile strength, but a larger strain at failure. The human TMF with a post-mortem interval of up to 146 h may be considered a mechanically suitable graft material for duraplasty when stored at a temperature of 4 °C.

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Section: Discussioncontrasting

confidence: 64%

Biomechanical characterization of human temporal muscle fascia in uniaxial tensile tests for graft purposes in duraplasty

Zwirner

Ondruschka

Scholze

et al. 2021

Sci Rep

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“…Recently, a study by Fam et al . observed a negative correlation of age with dural thickness of the skull base 36 . Therefore, it might be that the thickness of human cranial dura mater does not generally increase or decrease, but change site-dependently with age.…”

Section: Discussionmentioning

confidence: 85%

Mechanical Properties of Human Dura Mater in Tension – An Analysis at an Age Range of 2 to 94 Years

Zwirner

Scholze

Waddell

et al. 2019

Sci Rep

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Realistic human head models are of great interest in traumatic brain injury research and in the forensic pathology courtroom and teaching. Due to a lack of biomechanical data, the human dura mater is underrepresented in head models. This study provides tensile data of 73 fresh human cranial dura mater samples retrieved from an area between the anterior middle and the posterior middle meningeal artery. Tissues were adapted to their native water content using the osmotic stress technique. Tensile tests were conducted under quasi-static uniaxial testing conditions with simultaneous digital image correlation. Human temporal dura mater is mechanically highly variable with regards to its elastic modulus of 70 ± 44 MPa, tensile strength of 7 ± 4 MPa, and maximum strain of 11 ± 3 percent. Mechanical properties of the dura mater did not vary significantly between side nor sex and decreased with the age of the cadaver. Both elastic modulus and tensile strength appear to have constant mechanical parameters within the first 139 hours post mortem. The mechanical properties provided by this study can help to improve computational and physical human head models. These properties under quasi-static conditions do not require adjustments for side nor sex, whereas adjustments of tensile properties accompanied with normal aging may be of interest.

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“…That the sCSF leak group was 20 years older than both the SSWA and IIH groups suggests that additional age-related factors may be involved. Age-related dural attenuation may be an independent factor increasing the risk of CSF leak (23). Alternatively, or in combination, it may be that more time is needed for both the bony and dural dehiscence that are prerequisites for a sCSF leak to develop (26).…”

Section: Discussionmentioning

confidence: 99%

Imaging Characteristics of Sigmoid Sinus Wall Anomalies, Idiopathic Intracranial Hypertension, and Spontaneous CSF Leaks

Bhatnagar

Patel

Gourishetti³

et al. 2021

Otology &Amp; Neurotology

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Objective:To assess the frequency of radiographic features of elevated intracranial pressure (ICP) in patients with sigmoid sinus wall anomalies (SSWA) and compare to those in idiopathic intracranial hypertension (IIH) and spontaneous CSF (sCSF) leaks.Study Design:Retrospective review.Setting:Tertiary care center.Patients:110 patients - 62 SSWAs, 19 IIH, 29 sCSF leaks.Main Outcome Measures:Demographics, comorbidities and radiographic features by diagnosis.Results:Imaging findings indicative of elevated ICP were similar across all three groups, as were body mass index, hyperlipidemia and diabetes. On univariate analysis, sCSF leak patients were significantly older than SSWA (60 vs. 41 years, p < 0.001) and IIH (60 vs. 40 years, p < 0.001) patients. They had a greater prevalence of arachnoid granulations than SSWA (75.8% vs. 37.1%, p < 0.01) and tegmen dehiscence than both SSWA and IIH (93.1% vs. 75.8% vs. 57.8%, p = 0.01), though a lower prevalence of empty sella than SSWA (44.8% vs. 72.5%, p < 0.001). SSWAs were present in roughly 44.3% of IIH and sCSF leak patients, and IIH in roughly 15.8% of SSWA and sCSF leak patients. Age (OR = 1.1, p = 0.001), hypertension (OR = 8.3, p = 0.01) and empty sella (OR = 0.1, p = 0.01) were predictive of sCSF leaks compared to SSWAs on multivariate analysis.Conclusions:Many radiographic and clinical features of elevated ICP are found at similar rates among patients with SSWA, IIH and sCSF leaks, suggesting a common underlying process. SSWAs seem to present earlier along this spectrum of phenotypes, while sCSF leaks present later. Differences in age, metabolic syndrome and ICP may influence a patient's clinical presentation.

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Skull Base Dural Thickness and Relationship to Demographic Features: A Postmortem Study and Literature Review

Cited by 19 publications

References 21 publications

Biomechanical characterization of human temporal muscle fascia in uniaxial tensile tests for graft purposes in duraplasty

Biomechanical characterization of human temporal muscle fascia in uniaxial tensile tests for graft purposes in duraplasty

Mechanical Properties of Human Dura Mater in Tension – An Analysis at an Age Range of 2 to 94 Years

Imaging Characteristics of Sigmoid Sinus Wall Anomalies, Idiopathic Intracranial Hypertension, and Spontaneous CSF Leaks

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