CRANIAL FOSSAE AND ITS CONTENTS, NEUROANA

MENINGES, AND VENOUS SINUSES Lecture # 2

Dr. Edgar C. Gasco October 6, 2021
Transcribers: Hugo, Manco, Pepito
Editors: Manco, Velasco

OUTLINE
CRANIAL FOSSAE
I.CRANIAL CAVITY
Vault of the Skull
Base of the Skull
1. Anterior Cranial Fossa
2. Middle Cranial Fossa
3. Posterior Cranial Fossa
II. BRAIN MENINGES
A. Dura mater
B. Arachnoid mater
C. Pia mater
III. SPINAL MENINGES
A. Dura mater
B. Arachnoid mater
C. Pia mater
IV. VENOUS SINUSES

Figure 2. Calvaria: inferior view.

Must Know Book Prev Trans Lecturer
Ø In the midline is a shallow sagittal groove that lodges
I. CRANIAL CAVITY the superior sagittal sinus (See Figure 2)
Ø Contains the brain and its surrounding meninges, Ø Several narrow grooves are present for the anterior
portions of the cranial nerves (CNs), arteries, veins, and posterior divisions of the middle meningeal vessels
and venous sinuses. as they pass up the side of the skull to the vault (See
Figure 2,3 and Appendix – Figure 5
VAULT OF THE SKULL
Ø Internal surface of the vault shows the coronal,
sagittal, and lambdoid sutures (See Figure 1)

Figure 1. Coronal, sagittal, and lamboid sutures.

Figure 3. Cranial base: superior view.

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 BASE OF THE SKULL
Ø Divided into three cranial fossae: anterior, middle, and SPHENOID BONE
posterior (See Figure 3 and 4)
● Cranial bone with a flying bat-like appearance

LESSER WING OF SPHENOID BONE

● Serves a boundary between the anterior cranial fossa

and middle cranial fossa
● Contains the anterior clinoid process which serves
as the anterior attachment of the free border of
tentorium cerebelli

Clinical Correlations:

Ø Fractures of the anterior fossa may involve the cribriform

plate, accompanied by (1) lacerations of the meninges
and (2) lacerations of the mucous membrane of the roof
of the nose.
(1) Lacerations of the meninges and
(2) Lacerations of the mucous
Epistaxis (nose
membrane of the roof of the nose.
bleeding)
Accompanied/followed by a
discharge of CSF.

Due to lacerations of the olfactory

Loss of smell
nerves as they pass upward from the
after epistaxis
Figure 4. Internal surface of the base of the skull. nose

v ANTERIOR CRANIAL FOSSA Affords a route for infection to travel

Dural injury from the nose to the intercranial
Boundaries:
region
• Posteriorly à edges of the lesser wings of the
sphenoid Meningitis
• Medially à anterior edge of the optic groove of the Follows after fracture of the anterior
(Abscess in the
sphenoid cranial fossa.
frontal lobe)
Appearance:
• Floor of the Median Part à depressed; constitutes the Continuous discharge of CSF from
roof of the nasal cavity the nos
Cerebrospinal
• Median part à formed by the cribriform plate of e due to (1) failure of the cribriform
rhinorrhea
the ethmoid bone plate to heal after fracture and (2)
Lodges the: failure to repair dural lacerations
• Frontal lobes of the brain
If the fracture of the anterior fossa
• Olfactory bulbs and tracts Subconjunctival
involves the orbital plate of the frontal
hemorrhage
bone
ORBITAL PLATE OF FRONTAL
Protrusion of the eyeball.
● Forms the floor and roof of the orbit Occurs when the hemorrhage
Exophthalmos
(subconjunctival hemorrhage) seeps
CRIBRIFORM PLATE within the orbit.

● Cribriform means numerous openings (See Table 1) v MIDDLE CRANIAL FOSSA

● Part of the ethmoid bone that can be seen in the
anterior fossa
● Forms the roof part of the nose (See Appendix –
Figure 6)
● The olfactory bulb lodges here (See Appendix –
Figure 7)
● Olfactory fila are filaments that passes through the
numerous openings
CRISTA GALLI
● Serves as the attachment of the anterior end of the
falx cerebri (See Appendix – Figure 6)
● The frontal crest projects here
● Frontal crest and crista galli serve as the anterior
attachment of the falx cerebri
Ø Shaped like a “butterfly”. Have a small median and 2 lateral
expanded concave parts
Ø Cranial region with most numerous openings (makes it
‘weakest’ among three regions)
Boundaries:
• Floor of Median part formed by the upper surface of
the body of sphenoid
• Floor of Lateral part formed by
the greater wing of sphenoid
• the upper aspect of the petrous part of the temporal
and a portion of the squamous part of the temporal
bone.
• At the lateral parts of the floor of the middle cranial
fossa lodges the temporal lobes of the brain.

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GREATER WING OF SPHENOID BONE ● In between the tuberculum sellae and the dorsum
● Forms the wall of the middle cranial fossa sellae there is a concavity known as the sella
turcica
REGION OF ANTERIOR INFERIOR PORTION OF ● Inside this is the sphenoidal paranasal sinus
PARIETAL BONE ● NUMEROUS OPENINGS:
o Foramen Rotundum
● Also called PTERION - Situated behind the medial end of
● Boundary between the parietal, greater wing of the superior orbital fissure
sphenoid and squamosal of temporal - Perforates the greater wing of the
● Thinnest part of the lateral wall of skull sphenoid
● Significance: Beneath pterion lies the anterior - Transmits the maxillary nerve
branch of middle meningeal artery from the trigeminal ganglion to
● Most common cause of hemorrhage in brain: the pterygopalatine fossa
EXTRADURAL HEMORRHAGE (the artery o Foramen Ovale
involved is the middle meningeal artery especially - Lies posterolateral to the foramen
the anterior branches) rotundum
● Burr hole – when a surgeon opens a pterion; - Perforates the greater wing of the
important site for incision or opening (above sphenoid
zygomatic process) - Transmits the mandibular
division of the trigeminal nerve
OPTIC CANAL and lesser petrosal nerve to the
infratemporal fossa.
● Found at the lesser wing of sphenoid o Foramen Lacerum
● Transmits the optic nerve and the ophthalmic - Lies between the apex of the
artery, which is a branch of the internal carotid petrous part of the temporal bone
artery, to the orbit. and the sphenoid bone
- Formed by the basilar part of the
CHIASMATIC SULCUS/SULCUS CHIASMATIS occipital bone and the greater
wing of the sphenoid
● Related to the optic chiasma and leads laterally to
the optic canal on each side - Inferior opening of the foramen
lacerum in life is filled by
cartilage and fibrous tissue
SUPERIOR ORBITAL FISSURE
- Transmits the internal carotid
artery
● A slitlike opening between the lesser and greater
wings of the sphenoid
o Foramen Spinosum
● Transmits:
- where the middle meningeal
artery** passes
o Lacrimal nerve
o Frontal nerve **The middle meningeal artery isthe primary blood
o Trochlear nerve supply to the meninges and this is a branch of the
o Oculomotor nerve maxillary artery.The middle meningeal artery divides
o Nasociliary nerve into the anterior and posterior branch.
o Abducens nerve
o Superior ophthalmic vein SELLA TURCICA

BODY OF THE SPHENOID BONE ● Where the pituitary gland of the hypothalamus
lodges here
● Inside are the sphenoidal paranasal sinuses

Ø Clinical Correlation:
ü Middle cranial fossa à most common site of
fracture in the skull because of:
(1) its position
(2) presence of many foramina and canals.
ü Fractures may also pass through the sphenoid
bone or base of the occipital bone and cause
bleeding into the mouth.
ü Usually, tegmen tympani is fractured and
● Tuberculum sellae tympanic membrane torn. Then Blood and CSF
– Elevation that is posterior to the chiasmatic are discharged from the ex.auditory meatus
sulcus and appear at the ear. The facial and auditory
– Superior angles have two tubercles called nerves may be involved.
the posterior clinoid processes, which give ü At times, walls of the cavernous sinus are
attachment to the fixed margin of the tentorium lacerated and cranial nerves 3, 4 and 6,
cerebelli which lie in relation to its lateral wall may
● Dorsum sellae – square plate of bone that also be injured.
posteriorly bounds the sella turcica

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 v POSTERIOR CRANIAL FOSSA
Ø Largest and the deepest of the cranial fossae
Ø Floor: formed by the (1) basilar, (2) the condylar and
(3) the squamous parts of the occipital bone
Ø Lateral wall: formed by (1) the posterior surface of the
petrous and
(2) the medial surface of the mastoid part of the temporal bone
Lodges the: brain stem (cerebellum, pons and medulla
oblongata)
FORAMEN MAGNUM
● Greatest opening where the medulla oblongata
will pass through
● Serves as a boundary between the medulla
oblongata and spinal cord. Above is the medulla
oblongata, below is the spinal cord
● Transmits the spinal part of accessory nerve,
and right & left vertebral arteries
PETROUS BONE
● Serves as the boundary of the middle cranial fossa
and posterior cranial fossa
● Looks like a rock; petrous means rock or stone-
like hard
● Part of the temporal bone
● Contains numerous openings called the labyrinth.
The apparatus for hearing and equilibrium are
found in the labyrinth.
● Has numerous grooves:
o Superior petrosal sinus groove
o Arcuate eminence – rounded eminence
caused by the underlying superior
semicircular canal
o Hiatus groove for the greater petrosal
nerve
● Foramina or Openings in Petrous Bone (See Table
1):
o Internal Acoustic Meatus/Internal –
transmits the vestibulocochlear (CN VIII)
and facial nerves (CN VII)
o Jugular Foramen
- Boundary between the petrous
bone and occipital condyle
- Where the venous sigmoid
sinus drains
- 2 Compartments:
1. Posterior Compartment:
Where the Venous Sigmoid
Sinus passes through and
continues as the Jugular Vein.
2. Anterior Compartment:
Cranial nerves
(Glossopharyngeal),
(Vagus), and XI (Accessory or
Spinal Accessory) pass here
● Numerous Sinuses or Grooves of Sinuses (See
Appendix – Figure 5):
o Sigmoid sinus
o Transverse sinus
● Pathway: Left and Right Transverse Sinuses
→ Sigmoid Sinus → Jugular Foramina
Ø Clinical Correlation
• Fractures of posterior cranial fossa is more important
than other injuries because only a small fissure fracture
may prove to be fatal.
• Fractures may be overlooked since
(1) the bone is thin and (2) there is no outlet for the
escape of blood and CSF as in anterior and the middle
fossae.
• Blood may be noted over the mastoid process some days
after the injury.
• Fractures of the base of the skull involving the
hypoglossal canal may be manifested by paralysis of one
side of the tongue.
II. BRAIN MENINGES
• Membranous coverings of the brain and spinal cord
• Have three layers: (from superficial to the deep layer)
1. Dura mater
2. Arachnoid mater
3. Pia mater
A. DURA MATER
• A thick membrane made of dense irregular connective
tissue that surrounds the brain and spinal cord (toughest
and thickest; “durable”)
• Covers outgoing spinal nerves
• Described as two layers:
§ Endosteal / Periosteal layer
® Periosteum covering the inner surface of the skull
® At the foramen magnum: not continuous with dura
mater of the spinal cord
® At the sutures: continuous with sutural ligaments and
it is most strongly adherent.
§ Meningeal layer
® Dura mater proper
® Part of dura that covers the spinal cord
® Dense, strong fibrous membrane covering of the brain
▪ Provides tubular sheaths for the cranial nerves as
the latter pass through the foramina of the skull
® This layer sends inward four septa: the falx cerebri,
falx cerebelli, tentorium cerebelli, and diaphragma
sellae
IX
X

INTERNAL OCCIPITAL PROTRUBERANCE

● Corresponds to the site of the confluence of venous
sinuses (See Appendix – Figure 9)

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FOUR SEPTA
Ø Septa – Restricts the displacement of the brain
associated with acceleration and deceleration when
the head is moved
• Important structures derived from dura mater:

1. Falx Cerebri
® Sickle-shaped fold of dura mater
® Lies in the midline between the two cerebral
hemispheres
® Inserted in the longitudinal fissure
✔ Longitudinal fissure – prevents rotatory displacement
of brain
® Anterior end is attached to the internal frontal crest
and the crista galli
® Posterior end fuses with another dura mater structure
called tentorium cerebelli

DURAL NERVE SUPPLY

Possesses numerous sensory endings that are
sensitive to stretching, which produces the sensation
of headache
ü Includes branches of:
§ Trigeminal nerve (CN V)
§ Vagus nerve (CN X)
§ First three cervical spinal nerves
§ Branches from the sympathetic trunk

DURAL ARTERIAL SUPPLY

Arteries that supply the dura mater:
§ Internal carotid artery
§ Maxillary artery
§ Ascending pharyngeal artery
§ Occipital artery
2. Tentorium Cerebelli § Vertebral artery
® Crescent-shaped fold of dura mater From clinical standpoint, the most important is the
® Roofs over the posterior cranial fossa middle meningeal artery, which can be damaged in
head injuries
® Covers upper surface of the cerebellum
® Supports the occipital lobes of cerebral hemispheres
DURAL VENOUS SINUSES
® Lodged in transverse/horizontal fissure
§ Transverse/Horizontal fissure –separates Main function: Receive blood from the brain through
cerebrum from cerebellum the cerebral veins, and the CSF from the
® “Tentorial notch” - gap in the anterior edge; allows subarachnoid space through the arachnoid villi.
passage of the midbrain ● Involves the following:
ü Dural sinus
® Has 2 borders:
▪ Lined by endothelium
ü Free border
▪ Thick but devoid of muscular tissue
▪ Inner
▪ No valves
▪ Attached to anterior clinoid process
▪ Blood ultimately drains into the internal jugular veins
ü Fixed border
in the neck
▪ Outer
ü Emissary veins
▪ Attached mostly to bone (petrous bone & margin
▪ Valveless
3. Falx Cerebelli
® Small (compared to falx cerebri), sickleshaped fold of
§ Connect the dural venous sinuses with diploic
dura mater
veins of the skull and with the veins of the
® Attached to the internal occipital crest that projects scalp
forward between the two cerebellar hemispheres ü Superior sagittal sinus
® ▪ “Occipital sinus”: its fixed posterior margin ▪ Large sinus
▪ Receive tributaries from veins of the skull
4. Diaphragma Sellae Massive infection on skull → spread into superior sagittal
® Small, circular fold of dura mater sinus via diploic vein
® Forms the roof for the sella turcica ü Superior sagittal sinus and Transverse sinus
® A small opening in its center allows passage of the § Communicate through small openings with two
stalk of the hypophysis cerebri or three irregularly shaped venous lacunae

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 ü Inferior sagittal sinus
§ Occupies the free lower margin of the falx
cerebri
§ Middle cerebral veins drain here
§ Smaller in size compared to superior sagittal
sinus
ü Straight sinus
§ Line of junction of the falx cerebri with the
tentorium cerebelli
§ Formed by union of great cerebral vein and
inferior sagittal sinus
ü Transverse sinuses
§ Paired structures that begin at the internal
occipital protuberance
§ Receive superior petrosal sinuses, inferior
cerebral and cerebral veins and the diploic
§ veins
ü Sigmoid sinuses
§ Direct continuation of the transverse sinuses.
ü Occipital sinus
§ Small sinus occupying the attached margin
of the falx cerebelli
ü Cavernous sinuses
§ Situated in the middle cranial fossa on each
side of the body of the sphenoid bone
§ Spongy appearance
GREAT CEREBRAL VEIN
Ø Also known as “Great cerebral vein of GALEN”
Ø Drains into straight sinus (from diencephalon)
Ø Joins with inferior sagittal sinus to form straight sinus
Ø Excessive molding of the head / anteroposterior
compression of the head → tears anterior attachment
of falx cerebri from tentorium cerebelli →
INTRACRANIAL HEMORRHAGE (Bleeding from
great cerebral veins, straight sinus or inferior sagittal
sinus)
SUPERIOR CEREBRAL VEIN
Ø Drains into superior sagittal sinus
Ø Blow to the front or back of the head → excessive
anteroposterior displacement of the brain → tearing of
superior cerebral veins → SUBDURAL
HEMORRHAGE (more common than middle
meningeal hemorrhage)
B. ARACHNOID MATER
Ø Delicate, impermeable membrane covering the brain
Ø “Arachnoid” – filaments / spider-like
Ø Between the pia mater internally and the dura mater
externally
Ø The arachnoid mater and the pia mater together are
referred to as the leptomeninges
Ø Subdural space – potential space that separates
arachnoid mater from the dura mater; filled by a film of
fluid
Ø Subarachnoid space – separates arachnoid mater from
pia mater; filled with CSF
ü Cisterna – term used if space is wide
§ Subarachnoid cisternae – widely separates
arachnoid and pia
§ Cisterna cerebellomedullaries –between the
inferior surface of the cerebellum and the roof of
the fourth ventricle
§ Cisterna interpeduncularis –between the two
cerebral peduncles
[NEURO ANA] Cranial Fossae and its Contents, Meninges, and Venous Sinuses– Dr. Edgar Gasco
Ø Arachnoid villi – formed when arachnoid projects into the
venous sinuses. Also serve as sites where the CSF diffuses
into the bloodstream.
• CSF is produced by choroid plexus
• Arachnoid granulation – aggregations of arachnoid
villi
§ Site of CSF exit (side of superior sagittal
sinus)
§ Purulent meningitis → blocked CSF exit in
arachnoid granulation → increased
intracranial pressure because of obstruction of
flow
Ø Arachnoid forms a sheath for the optic nerve, which
extends into the orbital cavity through the optic canal
and fuses with sclera of the eyeball. Thus, the
subarachnoid space extends around the optic nerve.
C. PIA MATER
Ø Vascular membrane covered by flattened mesothelial cells
Ø Closely invests the brain, covering the gyri and descending
into the deepest sulci (innermost and thinnest)
Ø The cerebral arteries entering the substance of the brain
carry a sheath of pia with them
Ø It is the only meningeal layer that follows the contour of the
brain (the gyri and the fissures)
Ø It forms the tela choroidea
TELA CHOROIDEA
● Roof of the third and fourth ventricles of thebrain
● Fuses with the ependyma to form the choroid
plexuses in the lateral, third, and fourth ventricles of the
brain
III. SPINAL CORD MENINGES
SPINAL MENINGES
Ø The spinal cord in the vertebral column is also
protected by three layers of meninges, like the brain
A. DURA MATER
Ø Dense, strong, fibrous membrane that encloses the spinal
cord and the cauda equina
Ø Dural sheath lies loosely in the vertebral canal and is
separated from the wall of the canal by the extradural
space.
Ø Extradural space – Contains loose areolar tissue and the
internal vertebral venous plexus
B. ARACHNOID MATER
Ø Delicate impermeable membrane that covers the spinal
cord
Ø Internally – Lies between pia mater
Ø Externally – Lies between dura mater
Ø Subarachnoid space – Separates arachnoid mater from
pia mater; filled with CSF
Ø Inferiorly, it ends on the filum terminale at the level of the
lower border of the second sacral vertebra
Ø Continues along the spinal nerve roots
C. PIA MATER
Ø Vascular membrane that closely covers the spinal cord
Ø Ligamentum denticulatum – formed from thickened
pia mater on either side between the nerve roots;
passes laterally to adhere to the arachnoid and dura
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 IV. VENOUS BLOOD SINUSES
SUPERIOR SAGITTAL SINUS
Ø Lies in the upper fixed border of the falx cerebri (See
Appendix – Figure 12)
Ø Runs backward and becomes continuous with the
right transverse sinus
Ø The sinus communicates on each side with the
venous lacunae
ü Venous lacunae – concavities or granular pits
near the groove or sulcus of superior sagittal
sinus located on the cup or calvaria of the skull
Ø Receive tributaries from veins of the skull
Ø The superior sagittal sinus receives the superior
cerebral veins
Ø Massive infection on skull → spread into superior
sagittal sinus via diploic vein
Ø Confluence of venous sinuses – where superior
straight sinus and superior sagittal sinus communicate
INFERIOR SAGITTAL SINUS
Ø Lies in the free lower margin of the falx cerebri
Ø Runs backward and joins the great cerebral vein to
form the straight sinus (See Appendix – Figure 12)
Ø It receives cerebral veins from the medial surface of
the cerebral hemisphere
Ø Middle cerebral veins drain here
STRAIGHT SINUS
Ø Lies at the junction of the falx cerebri with the
tentorium cerebelli (See Appendix – Figure 12)
Ø Formed by the union of the inferior sagittal sinus with
the great cerebral vein
Ø Drains into the left transverse sinus
Ø Confluence of venous sinuses – where superior
straight sinus and superior sagittal sinus communicate
SUPERIOR PETROSAL SINUS
Ø Summit of petrous bone
Ø Drains into sigmoid sinus & cavernous sinus
TRANSVERSE SINUS
Ø Right transverse sinus begins as a continuation of the
superior sagittal sinus
Ø Left transverse sinus is usually a continuation of the
straight sinus
Ø Each sinus lies in the lateral attached margin of the
tentorium cerebelli, and they end on each side by
becoming the sigmoid sinus.
SIGMOID SINUSES
Ø Direct continuation of the transverse sinuses
[NEURO ANA] Cranial Fossae and its Contents, Meninges, and Venous Sinuses– Dr. Edgar Gasco
Ø Each sinus turns downward behind the mastoid
antrum of the temporal bone
Ø Leaves the skull through the jugular foramen to
become the internal jugular vein
OCCIPITAL SINUS
Ø Lies in the attached margin of the falx cerebelli
Ø Communicates with the vertebral veins through the
foramen magnum and the transverse sinuses.
CAVERNOUS SINUSES
Ø ● Lies on the lateral side of the body of the sphenoid
Ø bone, side of sella turcica (See Appendix – Figure 12)
Ø ● Anteriorly, the sinus receives the inferior ophthalmic
Ø Vein and the central vein of the retina.
ü Inferior ophthalmic vein
§ Communicates with facial vein with cavernous
sinus
§ Infection at “dangerous triangle” (upper lip and
nose) → spread from facial vein → cavernous
sinus via ophthalmic vein → cavernous sinus
thrombosis → death
Ø Drains posteriorly into the transverse sinus through
the superior petrosal sinus
Ø Communicates with intercavernous sinus which
connects the two cavernous sinuses through the sella
turcica
IMPORTANT STRUCTURES ASSOCIATED WITH THE
CAVERNOUS SINUSES:
Ø The internal carotid artery and the 6th cranial nerve
Ø In the lateral wall, the 3rd and 4th cranial nerves, and
the ophthalmic and maxillary divisions of the 5th
cranial nerve
Ø The pituitary gland, which lies medially in the sella
turcica
Ø The veins of the face, which are connected with the
cavernous sinus via the facial vein and inferior
ophthalmic vein, are an important route for the spread
of infection from the face
Ø The superior and inferior petrosal sinuses, which run
along the upper and lower borders of the petrous part
of the temporal bone
-END OF TRANSCRIPTION-
V. REFERENCES
ü Snell’s Clinical Neuroanatomy, 8th Edition
(Chapter 5, pp.191-195 & Chapter 15, pp. 418-
427)
ü Snell’s Clinical Anatomy, 9th edition (Chapter 11,
page 534-543)
ü Previous Trans by Batch Maximon
ü Dr. Gasco’s lecture
VI. FREEDOM WALL
Page 7 of 8
 VII. APPENDIX

Figure 7: Nerves of Nasal Cavity

Figure 8: Tentorium Cerebelli

Figure 9: Skull sectioned Horizontally (Super View)

Figure 5: SKULL (Midsagittal Section)

Figure 6: Medial Wall of the Nasal Cavity(Nasal Septum)

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