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Related Concept Videos

Cranial and Spinal Meninges01:19

Cranial and Spinal Meninges

The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
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Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...

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Related Experiment Video

Updated: Jul 5, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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[A study and follow-up of ten cases of benign enlargement of the subarachnoid spaces].

I Pascual-Castroviejo1, S I Pascual-Pascual, R Velázquez-Fragua

  • 1Servicio de Neurología Pediátrica, Hospital Universitario La Paz, Madrid, Spain. pascas@inves.es

Revista De Neurologia
|October 30, 2004
PubMed
Summary

Benign enlargement of the subarachnoid spaces typically resolves spontaneously, though it may take longer than expected. This condition appears hereditary, possibly due to cerebrospinal fluid absorption issues in infancy.

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Last Updated: Jul 5, 2026

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Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Developmental Pediatrics

Context:

  • Benign enlargement of the subarachnoid spaces (BESS) is a condition characterized by increased cerebrospinal fluid in the spaces surrounding the brain.
  • Macrocephaly in infants warrants thorough investigation to rule out serious underlying pathology.

Purpose:

  • This study presents 10 cases of benign enlargement of the subarachnoid spaces, detailing their clinical presentation and imaging evolution.
  • To observe the natural history and resolution patterns of BESS in a pediatric cohort.

Summary:

  • Ten infants (7 boys, 3 girls) presenting with macrocephaly were followed from birth. Imaging studies (CT and MRI) revealed enlarged subarachnoid spaces and ventricles peaking between 5-12 months, gradually resolving over time.
  • Monozygotic twins exhibited parallel disease progression, including possible cerebrospinal fluid reflux and septum pellucidum cyst formation, without impacting psychomotor development.
  • While BESS resolves spontaneously, resolution can be prolonged, with potential residual findings like hypotonus or attention deficits in some cases.

Impact:

  • Highlights the typically benign and self-limiting nature of BESS, reassuring clinicians and parents.
  • Suggests a possible hereditary component and impaired cerebrospinal fluid absorption as etiological factors.
  • Provides valuable longitudinal imaging and clinical data for understanding BESS progression and outcomes.