Johnston Kelly D, Walji Anil H, Fox Richard J, Pugh Jeffrey A, Aronyk Keith E
Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
J Neurosurg. 2007 Oct;107(4):841-3. doi: 10.3171/JNS-07/10/0841.
The purpose of this human cadaver study was to determine whether or not an intraosseous skull infusion would access the superior sagittal sinus (SSS) via intradural venous channels. The diploic space of the skull bone contains a sinusoidal vascular network that communicates with the underlying dura mater. Diploic veins in the parasagittal area connect with endothelium-lined intradural channels in the subjacent dura and ultimately with the dural venous sinuses. A significant proportion of cerebrospinal fluid (CSF) absorption is thought to occur via arachnoid granulations in the region of the SSS and especially along the parasagittal dura where arachnoid granulations are surrounded by intradural venous channels (lateral lacunae). The CSF is likely to be conducted from the subarachnoid space into the venous system via the fine intradural channels making up the lateral lacunae.
Infusion of vinyl acetate casting material into the diploic space of the human cadaveric skull resulted in complete filling of the lateral lacunae and SSS. Corrosion casting techniques and examination under magnification were used to characterize the anatomical connections between diploic spaces and dural venous sinuses.
Corrosion casting, performed on five formalin-fixed cadavers, clearly showed the anatomical connections between the diploic infusion site and the venous sinuses in the underlying parasagittal dura where some of the CSF is thought to be absorbed.
The diploic vascular channels of the human skull may represent an indirect pathway into the dural venous sinuses. Intraosseous skull infusion may represent another possible strategy for diversion of CSF into the vascular system in the treatment of hydrocephalus.
本人体尸体研究的目的是确定骨内颅骨输注是否会通过硬脑膜内静脉通道进入上矢状窦（SSS）。颅骨的板障间隙包含一个与下方硬脑膜相通的窦状血管网络。矢状旁区域的板障静脉与相邻硬脑膜内有内皮衬里的通道相连，并最终与硬脑膜静脉窦相连。据认为，相当一部分脑脊液（CSF）的吸收是通过上矢状窦区域，特别是矢状旁硬脑膜处的蛛网膜颗粒进行的，在那里蛛网膜颗粒被硬脑膜内静脉通道（外侧陷窝）包围。脑脊液可能通过构成外侧陷窝的细小硬脑膜内通道从蛛网膜下腔进入静脉系统。
将醋酸乙烯酯铸型材料注入人体尸体颅骨的板障间隙，导致外侧陷窝和上矢状窦完全充盈。采用腐蚀铸型技术并在放大条件下进行检查，以表征板障间隙与硬脑膜静脉窦之间的解剖连接。
对五具福尔马林固定的尸体进行的腐蚀铸型，清楚地显示了板障输注部位与下方矢状旁硬脑膜中静脉窦之间的解剖连接，据认为部分脑脊液在此处被吸收。
人类颅骨的板障血管通道可能代表进入硬脑膜静脉窦的一条间接途径。骨内颅骨输注可能是在脑积水治疗中将脑脊液引流至血管系统的另一种可能策略。
