Laboratoire d'anatomie, Université François Rabelais de Tours, France.
J Neurosurg. 2010 Nov;113(5):1045-52. doi: 10.3171/2010.1.JNS081701. Epub 2010 Feb 12.
The dura mater has 2 dural layers: the endosteal layer (outer layer), which is firmly attached to the bone, and the meningeal layer (inner layer), which directly covers the brain. These 2 dural layers join together in the middle temporal fossa or the convexity and separate into the orbital, lateral sellar compartment (LSC), or spinal epidural space to form the extradural neural axis compartment (EDNAC). The aim of this work was to anatomically verify the concept of the EDNAC by using electron microscopy.
The authors studied the cadaveric heads obtained from 13 adults. Ten of the specimens (or 20 perisellar areas) were injected with colored latex and fixed in formalin. They carefully removed each brain to allow a superior approach to the perisellar area. The 3 other specimens were studied by microscopic and ultrastructural methods to describe the EDNAC in the perisellar area. Special attention was paid to the dural layers surrounding the perisellar area. The authors studied the anatomy of the meningeal architecture of the LSC, the petroclival venous confluence, the orbit, and the trigeminal cave. After dissection, the authors took photographs of the dural layers with the aid of optical magnification. The 3 remaining heads, obtained from fresh cadavers, were prepared for electron microscopic study.
The EDNAC is limited by the endosteal layer and the meningeal layer and contains fat and/or venous blood. The endosteal layer and meningeal layer were not identical on electron microscopy; this finding can be readily related to the histology of the meninges.
In this study, the authors demonstrated the existence of the EDNAC concept in the perisellar area by using dissected cadaveric heads and verified the reality of the concept of the meningeal layer with electron microscopy. These findings clearly demonstrated the existence of the EDNAC, a notion that has generally been accepted but never demonstrated microscopically.
硬脑膜有 2 个硬膜层:紧贴骨的内膜层(外层)和直接覆盖大脑的脑膜层(内层)。这 2 个硬膜层在中颞窝或凸面连接在一起,并在眼眶、侧蝶鞍腔(LSC)或椎管硬膜外间隙分离,形成硬膜外神经轴腔(EDNAC)。本研究旨在通过电子显微镜对 EDNAC 的概念进行解剖学验证。
作者研究了 13 名成人的尸体头颅。10 个标本(或 20 个蝶鞍区)用有色乳胶注射并用甲醛固定。小心地取出每个大脑,以允许对蝶鞍区进行上入路。另外 3 个标本通过显微镜和超微结构方法进行研究,以描述蝶鞍区的 EDNAC。特别注意围绕蝶鞍区的硬膜层。作者研究了 LSC 的脑膜结构、岩斜坡静脉汇合处、眼眶和三叉神经窝的解剖结构。解剖后,作者借助光学放大拍摄硬膜层的照片。其余 3 个头颅取自新鲜尸体,准备进行电子显微镜研究。
EDNAC 由内膜层和脑膜层限制,包含脂肪和/或静脉血。内膜层和脑膜层在电子显微镜下并不相同;这种发现与脑膜的组织学密切相关。
在本研究中,作者通过使用解剖的尸体头颅证实了蝶鞍区 EDNAC 概念的存在,并通过电子显微镜验证了脑膜层概念的真实性。这些发现清楚地证明了 EDNAC 的存在,这一概念虽然已经被普遍接受,但从未在显微镜下得到证实。