Mast cells in the human dura: effects of age and dural bleeding

Varatharaj, Aravinthan; Mack, Julie; Davidson, Judith; Gutnikov, A.; Squier, Waney

doi:10.1007/s00381-012-1699-7

Cited by 20 publications

(14 citation statements)

References 23 publications

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“…Histamine released by mast cells directly produces release of neuropeptides from trigeminal nerve endings and augments the response to mechanical or chemical stimuli [21]. Dural mast cells show a reduction in density with age [31], but we are unable to say whether mast cell density in any way affects the density of dural innervation.…”

Section: Discussionmentioning

confidence: 94%

“…Increased head circumference is more common in male infants; in those with intracranial bleeding, the gender ratio was M3: F2 [35]. Dural bleeding causes inflammation [31] which is associated with dural neurogenic inflammation [29] leading to increased vascular permeability and dural effusion. The density of the dural nerves could potentially be an important factor in this condition.…”

Section: Discussionmentioning

confidence: 98%

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Developmental changes in human dural innervation

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 98%

Developmental changes in human dural innervation

et al. 2012

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“…We read with great interest the manuscript by Varatharaj and colleagues[2] regarding the presence of mast cells in the human dura. The authors should be applauded for their continued efforts to try to bring clarity to an area which remains opaque and complex; timing of subdural haemorrhage (SDH) collections.…”

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confidence: 99%

“…Sarkar and colleagues report the finding having been discovered by Yamashima and colleagues[3] demonstrating this finding as early as 1985. The most recent contribution by Varatharaj and colleagues[2], evaluating mast cell density within postmortem dural samples, is quite compelling, but given what is already known about the presence of eosinophils in subdural haemorrhage, some of the conclusions are unsupported by the data presented.…”

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Mast cells in the human dura: effects of age and dural bleeding

Greeley

Karst

2013

Childs Nerv Syst

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Retino‐Dural Hemorrhage of Infancy

Squier

2013

Wiley Encyclopedia of Forensic Science

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The term shaken baby syndrome (SBS), defined by the triad of retinal hemorrhage (RH), encephalopathy, and subdural hemorrhage (SDH), despite being widely accepted for 40 years, can no longer be regarded as a valid diagnosis. Multiple lines of evidence, from biomechanics to advances in understanding the anatomy and pathophysiology of the developing infant brain and its coverings, have undermined the diagnosis, and the nomenclature has been revised to reflect this. It is important to shift the focus to the objective pathological findings in babies with these closely interrelated phenomena rather than speculating on mechanisms; the term retino‐dural haemorrhage of infancy more accurately characterizes this syndrome. RHs have many causes and are more common after natural disease and accidents than after inflicted injury. Encephalopathy results from hypoxic‐ischemic injury rather than from traumatic axonal injury. Trauma is a cause of infant SDH, but there are many natural causes; almost half of normal newborns have SDH identified on brain scan. Infant SDH is usually a thin bilateral film, its source traditionally ascribed to torn bridging veins, but this remains unproved and is rarely documented. The dura is an alternative source; the infant dura is richly vascularized and innervated and bleeding into it is common. SDH evolves into a reactive membrane containing thin‐walled capillaries. Recurrent bleeding into these membranes is seen on microscopy. In some cases, SDH evolves into a chronic fluid collection; the causes for this are unknown. Biomechanical studies have shown that the forces generated by shaking are far less than those resulting from impact, but it remains correct to advise parents that babies should never be shaken. This article examines the pathology of each of these signs and their pathophysiology. The importance of considering the birth, early clinical history, and predisposing vulnerabilities when examining a case of suspected abuse is emphasized.

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Mast cells in the human dura: effects of age and dural bleeding

Abstract: 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.

Cited by 20 publications

References 23 publications

Developmental changes in human dural innervation

Developmental changes in human dural innervation

Mast cells in the human dura: effects of age and dural bleeding

Retino‐Dural Hemorrhage of Infancy

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