The Meninges and the

Cerebrospinal Fluid
The Meninges of Brain and Spinal
Cord
 The spinal cord and brain are surrounded by three
membranes, the meninges. Named from the outside
inward they are the dura mater, arachnoid(mater),
and piamater.
 Duramater = pachymeninges
 Arachnoidea + Piamater = Leptomeninges
 The meninges of spinal cord
 Duramater spinalis
 Arachnoidmater spinalis
 Piamater spinalis
 Duramater spinalis

Characters
 Above, attached to
circumference of foramen
magnum
 Below, becomes thinner at
level of S2, invests filum
terminale to attach at back
of coccyx
Spatium epidurale
 Position: lies between spinal dura mater and periosteum of vertebral canal
 Contents: a quantity of loose connective tissue, fat, lymphatic vessels and
vertebral venous plexus, the spinal nerves on each side pass through the epidural
space which is applicable for block anesthesia
Spatium subdurale
 Arachnoidmater spinalis
Characters
 A thin, delicate, tubular
membran loosely investing
spinal cord
 Above, it is continuous with
cerebral arachnoid mater
Spatium
subarachnoideum
Position: lies between pia and
arachnoid maters containing
cerebrospinal fluid
Terminal cistern : the largest part
of subarachnoid space extending
from termination of spinal cord to
level of S2, where it is occupied by
nerves of cauda equina, so it is the
best site for a lumbar puncture
Lumbar spinal puncture (spinal tap)
 Piamater spinalis
 A delicate vascular membrane that
closely invests the spinal cord
 Ligamentum denticulatum:
consist of 21 pairs triangular
ligaments extending from spinal
cord on each side between
anterior and posterior roots of
spinal nerves to spinal dura mate;
these ligaments help to fix
position of spinal cord.
 Filum terminale: an extension of
pia beyond conus medullaris
 The Meninges of Brain
 Duramater cerebri
 Arachnoidmater cerebri
 Piamater cerebri
 Duramater cerebri
Characters
 A thick and dense inelastic
membrane that composed of
two layers, an inner or
lamina meningealis and
outer or lamina endostealis
 It is in loose contact with
calvaria, and most strongly
adherent to base of skull
Four septa- Lamina meningealis
 Falx cerebri
 Tentorium cerebelli － in front there is a gap, the incisura
tentorial , for passage of midbrain
 Falx cerebelli
 Diaphragma sellae
Sistem sinus venosus
 Sinus sagittalis superior
 Sinus sagittalis inferior
 Sinus rectus
 Confluens sinuum
 Sinus transversus
 Sinus sigmoideus
 Sinus petrosus superior
 Sinus petrosus inferior
Sinus cavernosus
 Position: lies on each side of sella turcica
 Relations of cavernous sinus:
 Arteri carotis interna and abducent nerve run through the sinus
 Oculomotor and trochlear nerves and ophthalmic and maxillary
divisions of trigeminal nerve lie in the lateral wall of the sinus
 The flowing of the blood in dural
sinus
Sup. sagittal sinus

Inf. sagittal sinus Straight sinus Confluence of sinus Transverse sinus

Sup. petrosal sinus

Sigmoid sinus
Cavernous sinus

Inf. petrosal sinus Internal jugular vein

Arachnoidmater cerebri
 Characters: a delicate
membrane covering brain
loosely, passing over sulci
and entering only cerebral
longitudinal and transverse
fissures
 Consist of : membrana
arachnoidea and
trabecula arachnoidea
 Granulatio arachnoidea － project into sinuses of dura mater, serve as
sites where cerebrospinal fluid diffuses into bloodstream
 Cisterna subarachnoid c
 Cisterna
cerebellomedullaris
(magna)
 Cisterna
interpeduncularis
(basalis)
 Cisterna pontis
 Cisterna superior
(ambiens)
 Cisterna chiasmatis
 Cisterna lumbalis
Cerebellomedullary cistern
 Piamater cerebri
 Closely invests brain
surface, in some areas the
pia invaginates into
ventricles to take part in
the formation of choroids
plexus
Circulation of cerebrospinal fluid
(CSF)
 Cerebrospinal fluid is a clear
colorless fluid, which acts as a
transport medium for nutrients
and vaster products and
provides a protective fluid
cushion for the central nervous
system.
 Production: produced by the
choroids plexuses within the
lateral, third and fourth
ventricles
 Circulation of cerebrospinal fluid
CSF drains from lateral ventricle interventricular foramina third ventricle

mesencephalic aqueduct median and two lateral apertures

fourth ventricle

subarachnoid space arachnoid granulations superior sagittal sinus vein

Blood vessels of brain and spinal cord
 Arteries of brain
Two sources
 Arteri carotis interna:
supplies anterior 2/3 of
cerebral hemisphere
and parts of
diencephalon
 Arteri vertebralis:
supplies postterior 1/3
of cerebral
hemisphere and parts
of diencephalon, brain
stem and cerebellum
 Arteri carotis interna
 Arteri cerebri anterior
 Arteri cerebri media
 Arteri choroidea anterior
 Arteri communicans
posterior
Arteri cerebri anterior
 Joined the fellow of the
opposite side by the arteri
communicans anterior
 Cortical branches: supply
all medial surface of the
cerebral cortex as far back
as the parietooccipital sulcus
and superior border of the
suprolateral surface of the
cerebral hemisphere
 Central branches: supply
caudate nucleus, anterior
part of lentiform nucleus and
anterior limb of internal
capsule
Arteri cerebri media
 Cortical branches:
supply most of
superolateral surface of
cerebral hemisphere and
insular lobe
 Central branches:
supply lentiform and
caudate nuclei, genu and
posterior limb of internal
capsule (arteri
lenticulostriata )
 Arteri choroidea anterior:
passes backward, enters
inferior horn of lateral ventricle,
and ends in choroid plexus. It
supplies lateral geniculate
body, posterior limb of internal
capsule, middle 3/5 of crus
cerebri,and globus pallidus
 Arteri communicans posterior:
runs backward to join posterior
cerebral artery
Arteri vertebralis
Cranial branches
 Anterior and posterior spinal
arteries
 Posterior inferior cerebellar
artery
Arteri basilaris
 Anterior inferior cerebellar
artery
 Labyrinthine artery
 Pontine arteries
 Superior cerebellar artery
 Arteri cerebri posterior
Arteri cerebri posterior
 Cortical branches:
supply medial and
inferior surfaces of
temporal lobe and
occipital lobe
 Central branches:
supply dorsal thalamus,
medial and lateral
geniculate bodies,
hypothalamus and
subthalamus
Cerebral arterial circle ( arteriosus
circulus Willisi)
 Formation: formed by
anterior communicating
artery, both anterior
cerebral arteries, internal
carotid arteries, posterior
communicating arteries, and
posterior cerebral arteries
 Position: lies on sella
turcica around optic
chiasma, tuber cinereum
and mamillary bodies
 Area of oxygendeprives brain

Blockage

Thrombus

Plaque
 Microaneurysm

Lenticulostriate arteries

Subarachnoid hemorrhage
Intracerebral
hemorhage

Arteriovenous
malformation
 Veins of brain
Vena cerebri superficialis
 Drain blood from cortex

and subcortical
medullary substance and
empty into adjacent
sinuses of dura mater
 Veins of brain
 Vena cerebri
profunda: drain deeper
parts of hemispheres,
basal nuclei, internal
capsule, diencephalon
and choroid plexus,
ultimately form vena
cerebri magna which
enter straight sinus
Blood vessels of spinal cord
Arteries of spinal cord
 Two sources
 Arteri spinalis anterior (1)
and arteri spinalis posterior
(2)
 Branches of segmental
arteries: radicular arteries
of posterior intercostals
arteries, lumbar arteries,
and lateral sacral arteries
 Damage area:
T1~T4,ventral part of L1
 vascular ring
( vasocorona )
 Blood vessels of spinal cord
Spinal veins: drain into internal vertebral venous plexus