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Transitory block of the arachnoid granulations following subarachnoid haemorrhage

A postmortem study

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Summary

The arachnoid granulations of the superior sagittal sinus were examined for blockage by erythrocytes in 43 cases of subarachnoid haemorrhage. Ten cases had survived for more than two weeks after the haemorrhage.

Among 33 cases with acute haemorrhage, 17 had evidence of blocking of the granulations. The severity of the block varied from complete clogging of nearly all granulations to slight filling of a few of them. Cases with some days' survival showed evidence of phagocytosis of the entrapped erythrocytes by macrophages. Several of the cases with old haemorrhage had groups of haemosiderin macrophages in the granulations but none showed fibrosis (except for one single villus).

It is concluded that clogging of the arachnoid granulations may contribute to the raised intracranial pressure in some cases of acute subarachnoid haemorrhage. However, the observations do not support the hypothesis that the haemorrhage may lead to fibrosis or scarring of the granulations with chronic impairment of the cerebrospinal fluid resorption and subsequent hydrocephalus.

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References

  1. Adams, J. E., Prawirchardjo, S., Fate of red blood cells injected into cerebrospinal fluid pathways. Neurol.9 (1959), 561–564.

    Google Scholar 

  2. Alksne, J. F., Lovings, E. T., The role of the arachnoid villus in the removal of red blood cells from the subarachnoid space. An electron microscope study in the dog. J. Neurosurg.36 (1972), 192–200.

    PubMed  Google Scholar 

  3. Bradford, F. K., Johnson, P. D., Passage of intact iron-labeled erythrocytes from the subarachnoid space to the systemic circulation in dogs. J. Neurosurg.19 (1962), 332–336.

    PubMed  Google Scholar 

  4. Davson, H., Porous nature of the absorptive mechanism. In: Intracranial Pressure II, pp. 28–34 (Lundberg, N., Pontén, U., Brock, M., Eds.). Berlin-Heidelberg-New York: Springer. 1975.

    Google Scholar 

  5. —, Hollingsworth, G., Segal, M. B., The mechanism of drainage of the cerebrospinal fluid. Brain93 (1970), 665–678.

    PubMed  Google Scholar 

  6. Dupont, J., Van Wart, C. A., Kraintz, L., The clearance of major components of whole blood from cerebrospinal fluid following simulated subarachnoid hemorrhage. J. Neuropath. exp. Neurol.20 (1961), 450–455.

    PubMed  Google Scholar 

  7. Ellington, E., Margolis, G., Block of arachnoid villus by subarachnoid hemorrhage. J. Neurosurg.30 (1969), 651–657.

    PubMed  Google Scholar 

  8. Kennady, J. C., Investigations on the early fate and removal of subarachnoid blood. Pac. Med. Surg.75 (1967), 163–168.

    PubMed  Google Scholar 

  9. McQueen, J. D., Jelsma, L. F., Intracranial hypertension. Cerebrospinal fluid pressure rises following intracisternal infusions of blood components in dogs. Arch. Neurol.16 (1967), 501–508.

    PubMed  Google Scholar 

  10. - Northrup, B. E., Leibrock, L. G., Morooney, K., The sealing action of subarachnoid blood. In: Symposium on the cerebrospinal fluid in health and disease (Walker, A. E., Arana Iniques, R., Eds.). Acta Neurol. Latinoamericana, Suppl.1 (1972), 87–98.

  11. Plum, F., Siesjö, B. K., Recent advances in CSF physiology. Anesthesiol.42 (1975), 708–730.

    Google Scholar 

  12. Pool, J. L., Potts, D. G., Aneurysms and arteriovenous anomalies of the brain. Diagnosis and treatment. Hoeber Medical Division. Harper and Row, Publ. 1965.

  13. Potts, D. G., Gomez, D. G., Abbot, G. F., Possible causes of complications of water soluble myelography. Acta Radiol. In press, 1977.

  14. Russel, D. S., Observations on the pathology of hydrocephalus. Medical Research Council. Special Report Series No. 265. Her Majesty's Stationery Office. 1949. (Reprinted 1966).

  15. Shabo, A. L., Maxwell, D. S., The morphology of the arachnoid villi: A light and electron microscopic study in the monkey. J. Neurosurg.29 (1968), 451–463.

    Google Scholar 

  16. — —, Electron microscopic observations on the fate of particulate matter in the cerebrospinal fluid. J. Neurosurg.29 (1968), 464–474.

    Google Scholar 

  17. Turner, L., The structure of arachnoid granulations with observations on their physiological and pathological significance. Ann. Roy. Coll. Surg. Engl.29 (1961), 237–264.

    Google Scholar 

  18. Welch, K., Pollay, M., Perfusion of particles through arachnoid villi of the monkey. Amer. J. Physiol.201 (1961), 651–654.

    PubMed  Google Scholar 

  19. Wolpow, E. R., Schaumburg, H. H., Structure of the human arachnoid granulation. J. Neurosurg.37 (1972), 724–727.

    PubMed  Google Scholar 

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Author notes

  1. A. Torvik

    Present address: Laboratory of Neuropathology and Department of Neurosurgery, Ullevål Hospital, Oslo, Norway

  2. R. Bhatia

    Present address: All India Institute of Medical Sciences, New Delhi, India

  3. V. S. Murthy

    Present address: National Institute of Mental Health and Neurosciences, 560027, Bangalore, India

Authors and Affiliations

  1. Laboratory of Neuropathology and Department of Neurosurgery, Ullevål Hospital, Oslo, Norway

    R. Bhatia &  V. S. Murthy

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  1. A. Torvik
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  2. R. Bhatia
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  3. V. S. Murthy
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Torvik, A., Bhatia, R. & Murthy, V.S. Transitory block of the arachnoid granulations following subarachnoid haemorrhage. Acta neurochir 41, 137–146 (1978). https://doi.org/10.1007/BF01809144

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  • DOI: https://doi.org/10.1007/BF01809144

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