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1 2 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Telencephalon Prosencephalon Optic vesicle Diencephalon Mesencephalon Metencephalon Rhombencephalon Myelencephalon Spinal cord (a) 4 weeks (b) 5 weeks Telencephalon Forebrain Diencephalon Mesencephalon Midbrain Pons Metencephalon Cerebellum Hindbrain Myelencephalon (medulla oblongata) Spinal cord (c) Fully developed 3 4 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cerebral Rostral Caudal hemispheres Central sulcus Gyri Cerebrum Frontal lobe Lateral sulcus Central sulcus Temporal lobe Cerebellum Parietal lobe Brainstem Occipital lobe Spinal cord Longitudinal fissure (a) Superior view (b) Lateral view Precentral gyrus Central sulcus Postcentral gyrus Frontal lobe Parietal lobe Arachnoid mater Insula Temporal lobe Occipital lobe Cerebellum Blood vessels Medulla oblongata (c) Lateral view 5 c: © The McGraw-Hill Companies, Inc./Rebecca Gray, photographer/Don Kincaid, dissections 6 7 8 9 10 11 12 13 14 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Skull Dura mater: Periosteal layer Subdural space Meningeal layer Subarachnoid Arachnoid villus space Arachnoid mater Superior sagittal sinus Blood vessel Falx cerebri Pia mater (in longitudinal fissure only) Brain: Gray matter White matter 15 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Caudal Rostral Lateral ventricles Interventricular foramen Third ventricle Cerebral aqueduct Fourth ventricle Lateral aperture Median aperture Central canal (a) Lateral view 16 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cerebrum Lateral ventricle Interventricular foramen Third ventricle Cerebral aqueduct Fourth ventricle Lateral aperture Median aperture (b) Anterior view 17 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Arachnoid villus 8 Superior sagittal sinus Arachnoid mater 1 CSF is secreted by choroid plexus in Subarachnoid each lateral ventricle. space Dura mater 1 2 CSF flows through Interventricular foramina into third ventricle. 2 Choroid plexus 3 Third ventricle 3 Choroid plexus in third ventricle adds more CSF. 7 4 Cerebral 4 CSF flows down cerebral aqueduct aqueduct to fourth ventricle. Lateralaper ture 5 Choroid plexus in fourth ventricle adds more CSF. Fourth ventricle 6 5 6 CSF flows out two lateral apertures and one median aperture. Median aperture 7 CSF fills subarachnoid space and bathes external surfaces of brain and spinal cord. 7 8 At arachnoid villi, CSF is reabsorbed into venous blood of dural venous sinuses. Centralcanal of spinal cord Subarachnoid space of spinal cord 18 19 20 21 22 23 24 25 26 27 28 29 30 31 .

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Why Do Bridging Veins Rupture Into the Virtual Subdural Space?
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.47.2.121 on 1 February 1984. Downloaded from Journal of Neurology, Neurosurgery, and Psychiatry 1984;47:121-127 Why do bridging veins rupture into the virtual subdural space? T YAMASHIMA, RL FRIEDE From the Department ofNeuropathology, University of Gottingen, Gottingen, Federal Republic of Germany SUMMARY Electron microscopic data on human bridging veins show thin walls of variable thick- ness, circumferential arrangement of collagen fibres and a lack of outer reinforcement by arach- noid trabecules, all contributory to the subdural portion of the vein being more fragile than its subarachnoid portion. These features explain the laceration of veins and the subdural location of resultant haematomas. Most subdural haematomas due to venous bleeding walls are delicate, lacking muscle fibres, with only a have been attributed to lacerations in bridging veins. thin fibrous wall and a thin elastic lamina adjacent to These veins form short trunks passing directly from the endothelial layer. The conclusions of these two the brain to the dura mater, almost at right angles to authors, have gained wide acceptance, although guest. Protected by copyright. both. Between these two points, bridging veins take there was little evidence concerning the fragility of a straight course with no tortuosity to allow for the the vein walls. possible displacement of brain.' Trotter2 speculated The purpose of the present communication is to that subdural haematomas are invariably due to provide electron microscopic data on tissue fixed in trauma tearing large veins, an interpretation situ, which might throw some light on to the lacera- elaborated by Krauland.3 According to Leary,4 the tion mechanism of bridging veins and its relationship common sources of subdural haematomas are rup- to the development of subdural haematoma.
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