Breisch Eric, Haas Elisabeth A, Masoumi Homeyra, Chadwick Amy E, Krous Henry F
Department of Pathology, Rady Children's Hospital and Health Center, 3020 Children's Way, MC5007, San Diego, CA 92123, USA.
Forensic Sci Med Pathol. 2010 Dec;6(4):249-54. doi: 10.1007/s12024-009-9136-2. Epub 2010 Jan 20.
Literature addressing the anatomic development of the dura and calvarium during childhood is limited. Nevertheless, histological features of a subdural neomembrane (NM), including its thickness and vascularity, developing in response to an acute subdural hematoma (SDH) have been compared to the dura of adults to estimate when an injury occurred. Therefore, we measured the morphometric growth of the calvarium and dura and the vascular density within the dura during infancy. The mean thicknesses of the calvarium and dura as a function of occipitofrontal circumference (OFC), as well as the mean number of vessels per 25 × field, were determined from the right parasagittal midparietal bone lateral to the sagittal suture of 128 infants without a history of head trauma. Our results showed that as OFC increased, the mean thicknesses of the calvarium and dura increased while the vascular density within the dura decreased. Our morphometric data may assist in the interpretation of subdural NM occurring during infancy. We recommend future investigations to confirm and extend our present data, especially by evaluating cases during later infancy and beyond as well as by sampling other anatomic sites from the calvarium. We also recommend morphometric evaluation of subdural NM associated with SDH in infancy and childhood.
关于儿童期硬脑膜和颅骨解剖发育的文献有限。然而,已将因急性硬膜下血肿(SDH)形成的硬膜下新膜(NM)的组织学特征,包括其厚度和血管分布,与成人硬脑膜进行比较,以估计损伤发生的时间。因此,我们测量了婴儿期颅骨和硬脑膜的形态学生长以及硬脑膜内的血管密度。从128例无头部外伤史婴儿矢状缝右侧顶骨旁矢状面测量颅骨和硬脑膜的平均厚度与枕额周长(OFC)的关系,以及每25×视野的平均血管数。我们的结果显示,随着OFC增加,颅骨和硬脑膜的平均厚度增加,而硬脑膜内的血管密度降低。我们的形态学数据可能有助于解释婴儿期出现的硬膜下NM。我们建议未来的研究来证实和扩展我们目前的数据,特别是通过评估婴儿后期及以后的病例,以及从颅骨采集其他解剖部位的样本。我们还建议对婴儿期和儿童期与SDH相关的硬膜下NM进行形态学评估。