Bone Neoplasms ; pathology ; Chondrosarcoma, Mesenchymal ; pathology ; Dura Mater ; pathology ; Humans ; Meninges ; pathology

Among intracranial meningiomas, falcotentorial meningiomas, occurring at the junction of the falx cerebri and tentorial dural folds, are extremely rare. Because of their deep location, they are surrounded by critical structures, and have been regarded as one of the most challenging lesions for surgical treatment. In this study, we describe our surgical strategy for falcotentorial meningiomas and provide a review of our experience.
Adult ; Aged ; Dura Mater/pathology ; Female ; Humans ; Male ; Meningeal Neoplasms/pathology/*surgery ; Meningioma/pathology/*surgery ; Middle Aged

OBJECTIVESTo investigate the findings of magnetic resonance (MR) imaging and histopathology in early postoperative normal brain, and to define the correlation between MR images and histopathology.

METHODSThirty-six New Zealand rabbits weighing 2.0 to 3.0 kg were divided into 10 groups according to different postoperative days: 1 to 10 days. A partial resection of the parietooccipital region was performed under usual aseptic conditions after the animals were anesthetized intravenously with 3% pentobarbital (30 mg/kg). MR imaging procedures consisted of pre- and postcontrast scanning and were carried out on postoperative days 1 to 10. Brain tissue samples were prepared for examination immediately after MR scanning. Histopathological examination was done under light both and electron microscopes. The findings of MR imaging were compared with histopathologic findings.

RESULTSSurgical margin contrast enhancement on MR images could be seen 24 hours after surgery. The degree of contrast enhancement increased gradually up to 5 days postoperation, and no remarkable changes were present from days 5 to 10. Disruption of the blood brain barrier (BBB) was the main cause of contrast enhancement during the first 3 postoperative days. After that period, the mechanism responsible for contrast enhancement was the formation of neovascularity and a broken BBB. An increase in the amount of neovascularity played a predominant role in contrast enhancement in normal postoperative brain tissue.

CONCLUSIONSThe features of enhanced MR images present at the surgical margin followed a typical time course during the early postoperative period. The role of neovascularity and BBB disruption in the formation of contrast enhancement at the surgical margin varies with time. Knowledge of the features of contrast enhancement in postoperative MR images of normal brain can help in differentiating benign changes from residual malignant glioma.

Animals ; Brain ; pathology ; surgery ; ultrastructure ; Dura Mater ; pathology ; ultrastructure ; Edema ; pathology ; Magnetic Resonance Imaging ; methods ; Microscopy, Electron ; Rabbits

Dural enhancement detected by magnetic resonance imaging is a common finding in patients with cerebral venous sinus thrombosis (CVST) and is usually interpreted as a change secondary to CVST. We report two cases of CVST with intense and diffuse dural enhancement that resulted from pachymeningitis in one patient and spontaneous intracranial hypotension in another. Pachymeningitis and spontaneous intracranial hypotension were also determined to be the underlying causes of CVST. The clinical data of these two patients are described. In patients with CVST, dural enhancement is not always a secondary change to CVST. It can be a manifestation of the underlying causes of CVST. When diffuse and intense dural enhancement is revealed, sufficient ancillary tests are warranted to rule out other potential pathological changes of the dura mater those can result in CVST.
Adult ; Dura Mater ; pathology ; Female ; Humans ; Hypotension ; etiology ; Magnetic Resonance Imaging ; methods ; Meningitis ; etiology ; Sinus Thrombosis, Intracranial ; drug therapy ; etiology

Although intracranial dural metastasis of Ewing's sarcoma is a very rare finding, its imaging characteristics are similar to those of its primary form in the central nervous system. Thus, this tumor must be considered in the differential diagnosis of extra-axial dural masses.
Adult ; Dura Mater/*pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Sarcoma, Ewing's/diagnosis/*pathology/surgery ; Skull Neoplasms/diagnosis/*secondary/surgery ; Spinal Neoplasms/diagnosis/pathology/surgery ; Tomography, X-Ray Computed

OBJECTIVETo explore the value of spinal canal and dural sac dimensions for the treatment of lumbar disc herniation in MRI.

METHODSThe clinical data of 144 patients with single-level lumbar disc herniation underwent nonsurgical or surgical treatment from January 2010 to December 2012 were retrospectively analyzed. There were 91 patients in the nonsurgical group, including 55 males and 36 females, ranging in age from 20 to 68 years old with an average of (43.37±12.48) years; and there were 53 patients in the surgical group, including 28 males and 25 females, ranging in age from 20 to 64 years old with an average of (42.98±12.95) years. JOA scores (29 scores) were used to evaluate clinical manifestation (including subjective symptoms, objective findings, limitation of daily activities and bladder function) and outcomes. The parameters related to spinal canal and dural sac dimensions (including spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac cross-sectional area) in the initial axial T2-weighted MRI were measured, and odds ratio of available diameter to midsagittal diameter, odds ratio of lateral recess width to midsagittal diameter and area ratio of dural sac to spinal canal were calculated. Then, the differences of all parameters between two groups, and the correlations with initial JOA scores were analyzed.

RESULTS(1) All patients were followed up from 1 to 3 years with an average of 2.1 years. JOA scores before treatment were 16.27±2.96 in nonsurgical group and 12.64±3.30 in surgical group, there was statistically significant difference (t=6.319, P<0.01). At final follow-up time, there was no statistically significant difference in JOA scores (25.41±2.22 vs 25.76±2.29), improvement rate [(72.95±12.54)% vs (76.80±9.45)%], and the excellent and good rate (84.91% vs 78.02%) between two groups (P>0.05). But, the relapse rate of nonsurgical group was higher than surgical group (14.29% vs 5.67%). (2) Spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac area, the ratio of available diameter to midsagittal diameter, and the ratio of lateral recess width to midsagittal diameter in surgical group were smaller than that of nonsurgical group, but the area ratio of dural sac to spinal canal was larger, and there were statistically significant differences between two groups (P<0.01). (3) The initial JOA scores showed significantly positive correlation with spinal canal midsagittal diameter and available diameter, lateral recess width, and canal and dural sac area (P<0.01); also presented positive correlation with the ratio of available diameter to midsagittal diameter and the ratio of lateral recess width to midsagittal diameter (P<0.05); but there was a significantly negative correlation between initial JOA scores and the area ratio of dural sac to spinal canal.

CONCLUSIONBoth nonsurgical and surgical treatment of lumbar disc herniation can obtain good effect, but the recurrence rate of non-surgical treatment is higher. Preoperative MRI measurement parameters of spinal canal and dural sac dimensions has certain value for the treatment selection of lumbar disc herniation, but further refinement and validation is still required.

Adult ; Aged ; Dura Mater ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; pathology ; therapy ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Spinal Canal ; pathology

Intracranial cavernous angiomas are benign vascular malformations and can be divided into intra-axial and extra-axial lesions. Extra-axial cavernous angiomas are relatively rare and usually arise in relation to the dura mater and mimick meningiomas. We report a case of cavernous angioma that occured in the falx cerebri of a 22-yr-old female patient with the special focus on neuroradiologic findings. This is the fourth case of cavernous angioma in the falx cerebri reported in the literature to our knowledge.
Tomography, X-Ray Computed ; Meningeal Neoplasms/pathology/*radiography/surgery ; Magnetic Resonance Imaging ; Humans ; Hemangioma, Cavernous/pathology/*radiography/surgery ; Female ; Dura Mater/*pathology ; Adult

Metastasis of nasopharyngeal carcinoma (NPC) to the dura, an extremely rare condition, can be symptomatically silent and mistaken for a benign entity radiographically. Missed diagnosis can lead to serious consequences or prove immediately fatal. We report a woman with dural metastasis of NPC that mimicked a meningioma on radiography. Craniectomy with tumour resection was performed due to rapid progression from the onset of symptoms to disability. The patient was still alive two years after surgery. This case emphasises the need to keep in mind the possibility of dural metastasis of NPC in patients with abnormal imaging features. This would not only avoid wrong and optimistic diagnosis, but also allow for appropriate treatment in a timely manner. To our knowledge, this is the first report of metastasis of NPC to the dura. We provide detailed information on the neoplastic lesion, which masqueraded as a benign entity and caused potentially fatal consequences.
Adult ; Brain Neoplasms ; diagnosis ; secondary ; surgery ; Carcinoma ; Diagnosis, Differential ; Disease Progression ; Dura Mater ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Meningioma ; diagnosis ; pathology ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; Neoplasm Metastasis

In repeat lumbar surgery for failed back syndrome, well organized fibrous scar tissue is often noted, binding together the dura, nerve roots, and paraspinal muscles. An animal experimental study was done to investigate the prevention of scar formation after lumbar laminectomy by using dacron and sodium hyaluronate. The experimental animals consisted of three groups: 1) control group, 2) D group (covering the laminectomy defect with dacron sheet), and 3) H group (covering the laminectomy defect with sodium hyaluronate gel). Animals were sacrificed at varying intervals (3-12 weeks) and the lumbar spines were evaluated with histologic preparations. Scar adhesion to the dura was most significantly suppressed in the D group, followed by the H group and the control group.
Animal ; Cicatrix/etiology/*prevention & control ; Connective Tissue/pathology ; Disease Models, Animal ; Dura Mater/pathology ; Hyaluronic Acid ; *Laminectomy ; Polyethylene Terephthalates ; Postoperative Complications ; Rabbits ; Support, Non-U.S. Gov't ; Surgical Mesh

Langerhans cell histiocytosis (LCH) is a rare disorder histologically characterized by the proliferation of Langerhans cells. Here we present the case of a 13-year-old girl with LCH wherein CT and MRI results led us to an initially incorrect diagnosis of meningioma. The diagnosis was corrected to LCH based on pathology findings. An intracranial mass was found mainly in the dura mater, with thickening of the surrounding dura. It appeared to be growing downward from the calvaria, pressing on underlying brain tissue, and had infiltrated the inner skull, causing a bone defect. The lesion was calcified with the typical dural tail sign. The dural origin of the lesion was verified upon surgical dissection. There are no previous reports in the literature describing LCH of dural origin presenting in young patients with typical dural tail signs and meningioma-like imaging findings. The current case report underscores the need for thorough histological and immunocytochemical examinations in LCH differential diagnosis.
Adolescent ; Brain ; Diagnosis ; Diagnosis, Differential ; Dura Mater ; Female ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Magnetic Resonance Imaging* ; Meningioma* ; Pathology ; Skull ; Tail