缝合:蛛网膜下腔小梁的功能

D. Talbert
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引用次数: 5

摘要

摇晃婴儿假说认为大脑可以在颅骨内滑动,但小梁(连接蛛网膜下腔的胶原蛋白强化组织的细条)似乎可以防止这种情况发生。它们非常薄,无法被超声波或核磁共振成像系统检测到。上世纪70年代的儿科医生并不知道它们的存在。摇晃婴儿综合症假说忽略了它们。本研究的目的是探讨从SBS假设中省略小梁结构是否会对基于它的案件的法律有效性产生任何影响。当摇晃婴儿综合症的概念在20世纪70年代被提出时,人们认为在硬脑膜和蛛网膜之间有一层液体(“硬脑膜下空间”),它允许大脑皮层滑动。电子显微镜显示硬膜下腔不存在。电子显微镜显示了一个连接蛛网膜和网膜的组织(小梁)。“摇晃婴儿”模型中没有蛛网膜下腔,因此不考虑蛛网膜下腔小梁。这些蛛网膜下腔小梁内的胶原纤维与蛛网膜内层的胶原束和脑膜下间隙的胶原束连续,有效地将脑膜和蛛网膜“缝合”在一起。通过在尸体头部植入无线电不透明标记物和使用高速x射线记录仪,交通事故研究人员确定,新鲜的大脑具有软弹性。在冲击下,不同的区域以不同的速度在不同的位置上移动。这种小梁缝合导致大脑皮层表面紧密跟随颅骨运动。大脑皮层不能滑动,它会可逆地变形以进行运动。因此,桥静脉不能像20世纪70年代假设的那样被拉伸,摇晃婴儿综合症的假设是无效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Its a Stitch-Up: The Function of Subarachnoid Trabeculae
The Shaken Baby Hypothesis assumes the brain can slide in the skull, but trabeculae (thin strips of collagen reinforced tissue that link across the subarachnoid space) appear to prevent this. They are so thin that they are undetectable by ultrasound or MRI imaging systems. Pediatricians in the 1970s were unaware of their existence. The Shaken Baby Syndrome hypothesis ignores them. The purpose of this study was to investigate whether omitting the trabecular structures from the SBS hypothesis would have made any difference to the legal validity of cases based on it. When the Shaken Baby Syndrome concept was created in the 1970s it was believed that there was a layer of fluid between the Dura and Arachnoid Maters (a “Subdural Space”) which allowed the brain cortex to slide. Electron microscopy has since shown that the Subdural Space does not exist. Electron microscopy has shown a “Cob-Web” of tissue (Trabeculae) linking the Arachnoid and Pia Maters. There is no subarachnoid space in the “Shaken Baby” model so no subarachnoid trabeculae are considered. Collagen fibres within these subarachnoid trabeculae are continuous with bundles of collagen in the inner aspect of the arachnoid and with collagen bundles in the subpial space, effectively “stitching” the pia and arachnoid membranes together. By implanting radio-opaque markers in cadaver heads and using high speed X-ray recorders vehicle accident researchers established that fresh brain is softly elastic. Under impact various regions move over different loci at different speeds. This trabecular stitching causes the cerebral cortex surface to follow skull movement closely. The cortex cannot slide, it reversibly deforms to take up movements. Therefore the bridging veins cannot be strained as was assumed in the 1970s and the Shaken Baby Syndrome hypothesis is invalid.
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