Subject(s)
Pneumonia, Bacterial/diagnostic imaging , Aged , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Anti-Bacterial Agents/therapeutic use , Clarithromycin/therapeutic use , Diagnosis, Differential , Female , Humans , Pneumonia, Bacterial/drug therapy , Tomography, X-Ray ComputedSubject(s)
Cellular Senescence , Dura Mater/cytology , Hematoma, Subdural/pathology , Mast Cells , HumansABSTRACT
INTRODUCTION: There is limited published work on the abundant innervation of the human dura mater, its role and responses to injury in humans. The dura not only provides mechanical support for the brain but may also have other functions, including control of the outflow of venous blood from the brain via the dural sinuses. The trigeminal nerve supplies sensory fibres to the dura as well as the leptomeninges, intracranial blood vessels, face, nose and mouth. Its relatively large size in embryonic life suggests an importance in development; the earliest fetal reflexes, mediated by the trigeminal, are seen by 8 weeks. Trigeminal functions vital to the fetus include the coordination of sucking and swallowing and the protective oxygen-conserving reflexes. Like other parts of the nervous system, the trigeminal undergoes pruning and remodelling throughout development. METHODS: We have investigated changes in the innervation of the human dura with age in 27 individuals aged between 31 weeks of gestation and 60 years of postnatal life. Using immunocytochemistry with antibodies to neurofilament, we have found significant changes in the density of dural innervation with age RESULTS: The density of innervation increased between 31 and 40 weeks of gestation, peaking at term and decreasing in the subsequent 3 months, remaining low until the sixth decade. CONCLUSIONS: Our observations are consistent with animal studies but are, to our knowledge, the first to show age-related changes in the density of innervation in the human dura. They provide new insights into the functions of the human dura during development.
Subject(s)
Dura Mater/embryology , Dura Mater/growth & development , Trigeminal Nerve/embryology , Trigeminal Nerve/growth & development , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle AgedABSTRACT
BACKGROUND: Animal studies have shown that the dura mater contains mast cells. We investigated the density of mast cells in the human dura mater, and the changes associated with subdural haemorrhage (SDH). METHODS: Samples of the human dura were stained with tryptase antibody and were examined for mast cells. We used control cases with no dural bleeding (n = 9) and cases of fresh (n = 24) and old (n = 18) dural haemorrhage. RESULTS: Mast cells were easily found in dural samples. The mean density in controls (11.05 cells per mm(2)) was less than that in fresh SDH (15.69), which was less than that in old SDH (23.09). CONCLUSIONS: Subdural haemorrhage is associated with an increase in dural mast cell density, and the density increases as the haematoma ages. We hypothesise that dural mast cells may contribute to neurogenic inflammation and the clinical features of subdural haemorrhage.
