9 Antonio Pacchioni and Giovanni Fantoni on the Anatomy and ...
9 Antonio Pacchioni and Giovanni Fantoni on the Anatomy and ...
9 Antonio Pacchioni and Giovanni Fantoni on the Anatomy and ...
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-J Int Soc Plastinati<strong>on</strong> Vol 14, No 1: 9-11, 1999- 9<br />
<str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g> <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Giovanni</str<strong>on</strong>g> <str<strong>on</strong>g>Fant<strong>on</strong>i</str<strong>on</strong>g> <strong>on</strong> <strong>the</strong> <strong>Anatomy</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Functi<strong>on</strong>s of <strong>the</strong><br />
Human Cerebral Dura Mater<br />
Regis Olry<br />
Departement de chimie-biologie, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec,<br />
Canada<br />
(received March 22, accepted June 2,1999) Key words:<br />
Meninges - Arachnoid granulati<strong>on</strong>s - <str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g> <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> - <str<strong>on</strong>g>Giovanni</str<strong>on</strong>g> <str<strong>on</strong>g>Fant<strong>on</strong>i</str<strong>on</strong>g>.<br />
Abstract<br />
The western anatomical descripti<strong>on</strong>s of <strong>the</strong> human cerebral meninges still available date back to <strong>the</strong> mid-fourteenth century. Since<br />
that time, numerous anatomists made more or less accurate descripti<strong>on</strong>s of <strong>the</strong> human meninges <str<strong>on</strong>g>and</str<strong>on</strong>g> tried to underst<str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong>ir functi<strong>on</strong>s.<br />
Unfortunately, <strong>the</strong> belief in animal spirits led to esoteric interpretati<strong>on</strong>s which hindered <strong>the</strong> underst<str<strong>on</strong>g>and</str<strong>on</strong>g>ing of <strong>the</strong>se structures up to <strong>the</strong><br />
early eighteenth century. This paper summarizes <strong>the</strong> c<strong>on</strong>tributi<strong>on</strong>s of <str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g> <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Giovanni</str<strong>on</strong>g> <str<strong>on</strong>g>Fant<strong>on</strong>i</str<strong>on</strong>g> to <strong>the</strong> anatomy <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
functi<strong>on</strong>s of <strong>the</strong> meninges, respectively.<br />
Introducti<strong>on</strong><br />
Though Galen probably outlined <strong>the</strong> anatomy of <strong>the</strong><br />
meninges <str<strong>on</strong>g>and</str<strong>on</strong>g> its sinuses in <strong>the</strong> early first millennium<br />
(Dum<strong>on</strong>t, 1894), <strong>the</strong> descripti<strong>on</strong> of this part of neuroanatomy<br />
remained for a l<strong>on</strong>g time marked with esotericism (see Clarke<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Dewurst, 1984 <str<strong>on</strong>g>and</str<strong>on</strong>g> Corsi, 1990 for review). One of <strong>the</strong><br />
very first anatomical illustrati<strong>on</strong>s depicting <strong>the</strong> human<br />
meninges is to be found in Guido da Vigevano's manuscript<br />
"Liber notabilium" (1345): four plates show <strong>the</strong> chest of a<br />
trephined body <str<strong>on</strong>g>and</str<strong>on</strong>g> both dura <str<strong>on</strong>g>and</str<strong>on</strong>g> pia mater are outlined (Olry,<br />
1997). Subsequently, many anatomists tried to describe <strong>the</strong><br />
structure of <strong>the</strong> meninges <str<strong>on</strong>g>and</str<strong>on</strong>g> to underst<str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong>ir functi<strong>on</strong>s.<br />
Johannes Dry<str<strong>on</strong>g>and</str<strong>on</strong>g>er (1536, PI. 4) described two meningeal<br />
layers (probably <strong>the</strong> dura <str<strong>on</strong>g>and</str<strong>on</strong>g> pia mater). Some years later,<br />
Andreas Vesalius (1543) depicted <strong>the</strong> dura mater with its<br />
vessels (sinuses <str<strong>on</strong>g>and</str<strong>on</strong>g> middle meningeal artery) <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong> pia<br />
mater. In <strong>the</strong> mid-seventeenth century, Jean Riolan denied<br />
<strong>the</strong> existence of both layers of <strong>the</strong> cerebral dura mater<br />
(meningeal <str<strong>on</strong>g>and</str<strong>on</strong>g> endosteal, respectively), but <strong>the</strong>ir existence<br />
was c<strong>on</strong>firmed by Isbr<str<strong>on</strong>g>and</str<strong>on</strong>g> van Diemerbroeck (1695) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Philippe Verheyen (1708).<br />
<str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g> <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g> <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> (1665-1726), a friend <str<strong>on</strong>g>and</str<strong>on</strong>g> pupil of<br />
Marcello Malpighi, was particularly c<strong>on</strong>cerned with <strong>the</strong><br />
anatomy <str<strong>on</strong>g>and</str<strong>on</strong>g> functi<strong>on</strong> of <strong>the</strong> dura mater (Kemper, 1905;<br />
Norman, 1983; Eimas, 1990). In his 1701 treatise, he<br />
described in detail <strong>the</strong> tentorial incisure (<str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g>an<br />
foramen) <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong> structure of <strong>the</strong> falx cerebri, including its<br />
radiate fibres (figure 1). Unfortunately, he mistook <strong>the</strong>m for<br />
muscle <str<strong>on</strong>g>and</str<strong>on</strong>g> tend<strong>on</strong> bundles which were supposed to c<strong>on</strong>tract<br />
<strong>the</strong> falx <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong>refore compress <strong>the</strong> cerebral cortex. According<br />
to <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g>, this compressi<strong>on</strong> was intended to make <strong>the</strong><br />
cerebral gl<str<strong>on</strong>g>and</str<strong>on</strong>g>s secrete <strong>the</strong> animal spirits. The dura mater<br />
was <strong>the</strong>refore regarded as an "encephalic heart" (De Smet,<br />
1986), <str<strong>on</strong>g>and</str<strong>on</strong>g> a dozen years later, <strong>the</strong> medial <str<strong>on</strong>g>and</str<strong>on</strong>g> lateral<br />
l<strong>on</strong>gitudinal striae (Lancisi, 1713) were believed to be <strong>the</strong><br />
marks of <strong>the</strong> regular impacts of <strong>the</strong> falx <strong>on</strong> <strong>the</strong> superior surface<br />
of <strong>the</strong> corpus callosum.<br />
In a later dissertati<strong>on</strong> (1705), <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> made <strong>the</strong><br />
decripti<strong>on</strong> which made him find his place in <strong>the</strong> history of<br />
anatomy: he described <strong>the</strong> arachnoid granulati<strong>on</strong>s which are<br />
called "<str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g>an gl<str<strong>on</strong>g>and</str<strong>on</strong>g>s" since that time. These structures<br />
had been previously depicted by Andreas Vesalius (1543,<br />
Plates 7 <str<strong>on</strong>g>and</str<strong>on</strong>g> 66), but <strong>the</strong> author did not pay much attenti<strong>on</strong> to<br />
<strong>the</strong>m. The first plate of <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g>'s dissertati<strong>on</strong> was drawn<br />
by D. Moratori <str<strong>on</strong>g>and</str<strong>on</strong>g> engraved by N. Oddi. It depicts <strong>the</strong><br />
superior sagittal <str<strong>on</strong>g>and</str<strong>on</strong>g> transverse sinuses, <str<strong>on</strong>g>and</str<strong>on</strong>g> many arachnoid<br />
granulati<strong>on</strong>s are to be seen in <strong>the</strong> lumen of <strong>the</strong> superior sagittal<br />
sinus (figure 2). However, <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> believed that <strong>the</strong><br />
functi<strong>on</strong> of <strong>the</strong>se granulati<strong>on</strong>s was to secrete <strong>the</strong> cerebrospinal<br />
fluid.<br />
Address corresp<strong>on</strong>dence to: Dr. R. Olry, Departement de chimie-biologie, Universite du Quebec a Trois-Rivieres, C. P. 500,<br />
Trois-Rivieres, Quebec, CanadaG9A5H7. Teleph<strong>on</strong>e: 819 376 5053 /Fax: 819 376 5084. Email: Regis_Olry@uqtr.uquebec.ca
10 - J Int Soc Plastinati<strong>on</strong> Vol 14, No 1: 9-11, 1999<br />
<str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g> <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> made <strong>the</strong>refore accurate anatomical<br />
descripti<strong>on</strong>s, but misunderstood <strong>the</strong> functi<strong>on</strong>s of <strong>the</strong> dura<br />
mater <str<strong>on</strong>g>and</str<strong>on</strong>g> arachnoid granulati<strong>on</strong>s.<br />
<str<strong>on</strong>g>Giovanni</str<strong>on</strong>g> <str<strong>on</strong>g>Fant<strong>on</strong>i</str<strong>on</strong>g><br />
Some decades later, <str<strong>on</strong>g>Giovanni</str<strong>on</strong>g> <str<strong>on</strong>g>Fant<strong>on</strong>i</str<strong>on</strong>g> (1675-1758)<br />
corrected both <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g>'s mistakes: <strong>on</strong> <strong>the</strong> <strong>on</strong>e h<str<strong>on</strong>g>and</str<strong>on</strong>g>, he<br />
showed that <strong>the</strong> dura mater does not c<strong>on</strong>tain any muscular<br />
bundles, <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong> <strong>the</strong> o<strong>the</strong>r h<str<strong>on</strong>g>and</str<strong>on</strong>g> he asserted that <strong>the</strong> arachnoid<br />
granulati<strong>on</strong>s are in charge of <strong>the</strong> reabsorpti<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> not<br />
secreti<strong>on</strong>, of <strong>the</strong> cerebrospinal fluid: "The humoral flow is<br />
sent to <strong>the</strong> superior sagittal sinus ra<strong>the</strong>r than to <strong>the</strong> hemisphere<br />
c<strong>on</strong>vexity. This is more in line with <strong>the</strong> laws of nature, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<strong>the</strong> sinus itself, <str<strong>on</strong>g>and</str<strong>on</strong>g> not <strong>the</strong> meninges, is irrigated by this<br />
liquid, <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong> blood will <strong>the</strong>refore be diluted" (1738).<br />
Discussi<strong>on</strong><br />
Though he misunderstood <strong>the</strong> nature of <strong>the</strong> fibrous tracts<br />
in <strong>the</strong> falx cerebri <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong> real functi<strong>on</strong> of <strong>the</strong> arachnoid<br />
granulati<strong>on</strong>s, <str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g> <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> has to be regarded as a<br />
pivotal figure in <strong>the</strong> history of <strong>the</strong> anatomy of human<br />
meninges. He described <strong>the</strong> tentorial incisure <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>the</strong><br />
arachnoid granulati<strong>on</strong>s which had <strong>on</strong>ly been menti<strong>on</strong>ed by<br />
his predecessors, <str<strong>on</strong>g>and</str<strong>on</strong>g> his name rapidly appeared in <strong>the</strong> studies<br />
of his c<strong>on</strong>temporaries (Heister, 1719). That is why <str<strong>on</strong>g>Ant<strong>on</strong>io</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g> became ep<strong>on</strong>ymous in <strong>the</strong> medical professi<strong>on</strong>.<br />
Figure 1. Plate 1 of <str<strong>on</strong>g>Pacchi<strong>on</strong>i</str<strong>on</strong>g>'s 1701 treatise. The radiate<br />
fibres of <strong>the</strong> falx cerebri were believed to be muscular<br />
bundles.<br />
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