Kawano N, Endo M, Saito M, Yada K
Department of Neurosurgery, Kitasato University School of Medicine, Kanagawa, Japan.
No Shinkei Geka. 1988 May;16(6):747-52.
To understand the early stage of subdural neomembrane (SN) formation, we examined 23 outer SNs and two inner SNs of chronic subdural hematomas in surgical specimens. Ultrastructurally, the cellular component of the outer SN was fibroblasts, myofibroblasts, smooth-muscle cells (in four cases), blood vessels and blood-born cells. Dural border cells were observed only in limited areas. Namely, the outer SN is a simple granulation tissue which originates from multiple sources of mesenchymal cells in dura mater, and dural border cells are only one of constituent sources for SN formation. The inner SN was simply composed of slender spindle cells which were mostly fibroblasts and some were recognized as dural border cells. Our results showed that the subdural hematoma is actually an "intra" dural hematoma which is formed within the split dural border cell layer. The dura mater with rich vascular supply forms thick granulation tissue, that is outer SN and a few dural border cells on the underlying arachnoid membrane form thin fibrous inner SN.
为了解硬脑膜下新膜（SN）形成的早期阶段，我们检查了手术标本中23个慢性硬脑膜下血肿的外层SN和2个内层SN。超微结构上，外层SN的细胞成分是成纤维细胞、肌成纤维细胞、平滑肌细胞（4例）、血管和血源性细胞。仅在有限区域观察到硬脑膜边界细胞。也就是说，外层SN是一种简单的肉芽组织，起源于硬脑膜中间充质细胞的多个来源，而硬脑膜边界细胞只是SN形成的组成来源之一。内层SN仅由细长的梭形细胞组成，这些细胞大多是成纤维细胞，有些被认为是硬脑膜边界细胞。我们的结果表明，硬脑膜下血肿实际上是一种“硬脑膜内”血肿，它形成于硬脑膜边界细胞层的分裂内。血管供应丰富的硬脑膜形成厚的肉芽组织，即外层SN，而蛛网膜下膜上的一些硬脑膜边界细胞形成薄的纤维状内层SN。
