THE MENINGES
The
meninges covering the central nervous system are composed of three layers: the
dura mater, the arachnoid mater and the pia mater. The arachnoid and pia
jointly form the leptomeninges.
The dura mater (pachymeninx) is a
tough, dense membrane which surrounds the brain. It has two extensions: the
faix, between the two cerebral hemispheres,
and the tentorium
cerebelli, separating the contents of the posterior fossa from the rest
of the brain. The cranial dura is closely attached to the skull; its two
layers, the periosteal and meningeal dura, are fused and separate only to form
the venous sinuses. In the spinal canal, however, the dura is separated from
the vertebral periosteum by the epidural space, which contains fibro-fatty
tissue and an epidural venous plexus.
The dura is formed by dense,
interlacing bundles of collagen in which flattened fibroblasts are embedded.
The central part contains more cells and occasional blood vessels. Its outer
surface is covered by thin, overlapping cell processes and its inner border
also has a covering of flattened cells. The subdural space is artefactual,
since the dura and arachnoid are closely apposed in life with no appreciable
gap between them.
The arachnoid mater has a variable
thickness, in places being formed by several cell layers. Its outer, dural
aspect is smoother than the inner, pial -aspect from which trabeculae emerge to
bridge the subarachnoid space. The arachnoid cells are joined together by
specialised contacts, including tight junctions, which ensure an effective
physiological barrier impermeable to CSF.
The cells of the pia mater are
similar to those of the arachnoid, but the pia itself is thinner than the
arachnoid. Pial cells form a complete layer joined by desmosomes and gap
junctions.156 The subpial space separates the pia from the glia
limitans of the underlying neural tissue and the pia mater separates the
subarachnoid space from the perivascular (Virchow-Robin) spaces of the brains.
Arachnoid villi are diverticula of
the arachnoid mater and the subarachnoid space which extend into veins and
venous sinuses of the dura. Arachnoid granulations are larger than villi and
are visible to the naked eye, whereas villi are microscopical structures. Each
villus or granulation is coated on its venous aspect by endothelial cells and
is bathed by venous blood. As the villus or granulation penetrates the dura, it
forms a narrow neck which then expands to form a central core composed of
channels and collagenous trabeculac. Towards the apex of the granulations there
is a cap of arachnoid cells with wide channels running through to the coating
endothelium.15~ These structures are a major pathway for the
drainage of cerebrospinal fluid, which percolates through the cores of the
villi or granulations and is transported across the endothelium into the blood.
THE SUBEPENDYMAL PLATE
The subependymal plate has long been
recognised as a layer of primitive cells beneath the ependymal lining of the
lateral ventricles in the adult human ~ It is the remnant of the embryonal
matrix (the subventricular zone). Studies of the subependymal plate
in various animal species have revealed that in the fetus it gives rise to both
neurons and glia, whilst after birth it is a source of glial cells oflly.161~162
The cells of the subependymal plate display ultrastructural features
common to primitive cells: high nuclear-cytoplasmic ratio, dominance of free
ribosomes over membrane-bound ribosomes and a general scarcity of organelles.
Mitotic activity persists into later adult life in various species,
including primates.Unfortunately, information on the human subependyn
extrapolation from may be misleading.
Human subependymal plate is limited,
and an extrapolation from experimenta] animals to man may be misleading.
In addition to the subependymal
plate there are other secondary germinal sites in the mammalian central nervous
system, including the dentate gyrus of the hippocampus, the olfactory bulb and
the external granular layer of the cerebellum. This latter zone, which has been
more comprehensively studied than the other two, is formed in fetal life and
postnatally continues to produce the neurons of the internal granular layer.
The proliferative activity of these secondary germinal zones and the hormonal,
nutritional and pharmacological factors which influence cellular turnover have
been reviewed.'67
The presence of the subependymal
plate with potential mitotic activity in the adult human brain raises the
question of the replacement of glial cells and of their proliferative activity
in the normal brain. The view that cells of the adult central nervous system do
not divide cannot be maintained any longeri68 as there is
convincing evidence that astrocytes and cells of the subependymal plate
maintain mitotic activity throughout adult life. Although oligodendrocytes
undergo mitosis in pathologica] conditions,'69 their ability to
divide in the normal brain has not been unequivocally demonstrated. Similarly,
microglial cells do not appear to be mitotically active in the normal, adult
central nervous system. Neurons, ependymal cells, choroid plexus epithelium and
pericytes do xiot divide after they have become differentiated, whilst
endothelial cells continue to undergo mitosis during adult life.'68 The
low turnover of cells in the adult central nervous system, coupled with the
difficulty of positively identifying dividing cells and the occasional cell
which is not fully differentiated, makes precise assessment of the mitotic
activity of a particular cell type difficult. Moreover, recent tissue culture
studies of the developing rat optic nerve have revealed that glial precursors,
depending on the composition of the culture medium, can differentiate into
either astrocyte or oligodendrocyte even without the influence of other brain
cells.170 If these cells persist into adult life thcy may retain
their differentiation potential and mitotic activity.