DOCSLIB.ORG

Partial, Non-Thrombotic, Superior Sagittal Sinus Occlusion Due To

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Partial, Non-Thrombotic, Superior Sagittal Sinus Occlusion Due To 520 Journal of Neurology, Neurosurgery, and Psychiatry 1991;54:520-523 Partial, non-thrombotic, superior sagittal sinus J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.54.6.520 on 1 June 1991. Downloaded from occlusion due to occipital skull tumours G T Plant, J J Donald, A Jackowski, S J Vinnicombe, B E Kendall Abstract signs on neurological examination. Visual Two cases are described in which raised acuity was 6/6 bilaterally and the blind spots intracranial pressure occurred as a enlarged on visual field testing. A CT brain result of superior sagittal sinus (SSS) scan was carried out but neither enlargement occlusion by an occipital skull tumour. of the ventricular system nor a mass lesion One was a plasmacytoma, the other a were found and the scan was at first considered metastatic deposit from a Ewing's sar- to show no abnormality. CSF examination coma. The difficulties in diagnosis of revealed an opening pressure of greater than this syndrome are illustrated together 40 cm of CSF. The protein content was with the importance and success of 0 26 g/L and the glucose 5 5 mmol/L with no appropriate treatment. From the increase in cellularity and no malignant cells literature it appears possible that these seen on cytological examination. He was fol- two tumours may be particularly likely lowed for a further four weeks during which to occlude the SSS and the reasons for time he began to notice loss of vision. On this are discussed. examination he then showed constriction of visual fields and he was admitted for further investigation. A further CT brain scan Superior sagittal sinus (SSS) thrombosis is a showed midline destruction of the occipital well recognised cause of raised intracranial bone with an associated soft tissue mass (fig pressure. Less attention has been paid to the IA). In retrospect this lesion had been visible, fact that midline tumours in the occipital although considerably less obvious, on the first region of the skull can give rise to raised CT scan. A digital subtraction angiogram intracranial pressure secondary to non-throm- (DSA) showed in the venous phase partial botic compressive occlusion of dural venous occlusion of the SSS with an adjacent sinuses. The purpose of this article is to report "tumour blush" (fig 1B). two such cases illustrating the difficulties in He was treated with 20 gy to the whole making the diagnosis if the possibility is not brain in five fractions with steroid cover. Over actively considered. The importance of recog- two weeks there was further visual loss and his the is also clear as both a nising syndrome acuity fell to 6/18 bilaterally despite further http://jnnp.bmj.com/ lesions were successfully treated: one case was therapeutic lumbar puncture. A second DSA treated by excision of the tumour and we showed no improvement in the occlusion of know of no previous report of a similar case the sinus. It was therefore decided, eight managed surgically. A survey of the literature weeks following the diagnosis of raised suggests that the underlying pathologies in intracranial pressure, to treat the lesion sur- these two cases, plasmacytoma and Ewing's gically. An occipital craniotomy was perfor- sarcoma, may be particularly likely to produce med and at operation the plasmacytoma was raised intracranial pressure by this mechan- readily peeled off the dura of the compressed on September 25, 2021 by guest. Protected copyright. ism. SSS, which visibly re-expanded at the end of Middlesex Hospital, the procedure. Following surgery there was an London, UK Department of immediate symptomatic improvement in Neurology Case reports visual function. A month later the optic discs G T Plant Case one were flat and the visual fields were normal, Department of A 42 year old West Indian man presented including the size of the blind spots, but the Neurosurgery with rib fractures. (IgA A Jackowski multiple Myeloma acuity impaired at 6/18 bilaterally. Six months Kappa) was diagnosed on bone biopsy. He later there had been no further improvement Department of Radiology was treated with intermittent chemotherapy and optic atrophy was noted. J J Donald for ten years with a good response. The course B E Kendall of the illness was one of recurrent plasma- Department of cytomas, often producing pathological Case two Medicine without evidence of bone marrow S J Vinnicombe fractures, A 19 year old warehouseman developed plasmacytosis. During the course of the dis- progressive left hip and knee pain over a Correspondence to: Dr Plant, The National ease he developed paraplegia secondary to period of six months. He then experienced Hospital for Neurology and compression of the spinal cord by a myeloma severe generalised headaches associated with Neurosurgery, Queen Square, London WCIN deposit in the body of T8. This responded to vomiting. Four days following the onset of the 3BG, UK treatment with steroids and radiotherapy. headaches he experienced visual obscurations Received 13 March 1990 At the age of 54 he complained of mild and intermittent horizontal diplopia. On and in revised form 20 July 1990. headaches and was noted to have bilateral examination he was afebrile without neck stiff- Accepted I November 1990 papilloedema. There were no other abnormal ness. Movements of the left hip and knee were Partial, non-thrombotic, superior sagittal sinus occlusion due to occipital skull tumours 521 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.54.6.520 on 1 June 1991. Downloaded from Figure I (A) Contrast enhanced CT brain scan (case one) showing a midline occipital skull defect due to a plasmacytoma (arrow). (B) Venous phase ofDSA (case one) showing compression of the terminal portion of the SSS by the plasmacytoma, visible as a "tumour blush" (arrow). painful. Visual acuity was normal but the to 14 cm of CSF. The CSF protein was blind spots were enlarged on examination of 0-12 g/L, glucose 4-0 mmol/L, there was no the visual fields. There was bilateral weakness increase in cellularity and no malignant cells of the lateral recti and, on fundoscopy, were seen on cytological examination. Follow- bilateral papilloedema with haemorrhages. ing this procedure his headaches resolved and There were no focal neurological signs in the visual obscurations abated. An intravenous limbs. DSA was carried out which showed marked A radiograph of the left femur revealed an extrinsic compression of the SSS at the level extensive permeative lytic lesion involving the of the internal occipital protuberance (fig 2A). mid shaft with a periosteal reaction. A needle An isotope bone scan of the whole skeleton biopsy showed histological features typical of was later carried out showing increased uptake Ewing's sarcoma. A chest radiograph was nor- in the left femur, knee and ankle and at the mal. An unenhanced CT scan of the brain inion (fig 2B). http://jnnp.bmj.com/ showed ventricles of normal size and no Following these investigations the CT scan evidence of an intracranial mass. A lumbar was repeated. A scan with bone windows puncture was carried out. The opening pres- confirmed a prominent internal occipital sure was greater than 40 cm of CSF, and CSF protruberance but there was no evidence of was withdrawn until the pressure was reduced bone destruction. A CT scan with contrast on September 25, 2021 by guest. Protected copyright. (A 0 i ,<*s~~~ Az t. :: , .41 .. a. 0-cr't'. Figure 2 (A) Venous phase of DSA (case two) showing afilling defect in the terminal portion of the SSS which is compressed at this point (arrow). (B) Isotope bone scan showing high uptake at the inion (case two). 522 Plant, Donald, Jackowski, Vinnicombe, Kendall enhancement (fig 3) showed enhancement J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.54.6.520 on 1 June 1991. Downloaded from coinciding with the position at which the SSS normally divides to form the transverse sinuses (the torcular Herophili). These appearances are similar to normal enhance- ment of the dural sinuses at this point. In view of the fact that this coincides with the site of obstruction of the sinus on the DSA it was concluded that the enhancement was not of the sinus but an extradural metastatic deposit which had not caused any alteration in the appearance of the inner table of the skull. The patient was treated with combination chemotherapy on the UKCCSG protocol with IVAD (Ifosfamide, Vincristine and Adriamycin) as well as with concomitant radiotherapy to the left femur. Because of the tumour's extreme chemosensitivity, local Figure 4 Following treatment of case two with radiotherapy to the occipital metastasis was chemotherapy the SSS no longer appears compressed thought unnecessary. Over a period of three (compare fig 2A). weeks his papilloedema and weakness of the lateral recti resolved and there was no cribed by Averback3 and reviewed by Sigsbee et recurrence of headaches. al.4 SSS thrombosis may also occur as a "non- Follow up DSA (fig 4: four weeks following metastatic" complication of cancer.4 Mones5 the examination shown in fig 2A) showed a and, Korenman and Mones,6 however, des- normal appearance of the SSS in the venous cribed a series numbering 18 cases ofneoplastic phase of the angiogram with no evidence of disease with evidence of raised intracranial compression. The CT scan was not repeated. pressure without focal signs and without hydrocephalus or mass lesions. These cases have been incorrectly quoted as examples of Discussion SSS compression leading to thrombosis47 but The most recent review articles which have in fifteen cases it was shown angiographically or discussed raised intracranial pressure due to at necropsy that the SSS and torcular were dural sinus occlusion have concentrated on occluded or partially occluded by extradural dural sinus thrombosis.'2 Published cases of compression without thrombosis.
Load more

Recommended publications
  • Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations
    ORIGINAL RESEARCH INTERVENTIONAL Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations Z.-S. Shi, J. Ziegler, L. Feng, N.R. Gonzalez, S. Tateshima, R. Jahan, N.A. Martin, F. Vin˜uela, and G.R. Duckwiler ABSTRACT BACKGROUND AND PURPOSE: DAVFs rarely involve the sphenoid wings and middle cranial fossa. We characterize the angiographic findings, treatment, and outcome of DAVFs within the sphenoid wings. MATERIALS AND METHODS: We reviewed the clinical and radiologic data of 11 patients with DAVFs within the sphenoid wing that were treated with an endovascular or with a combined endovascular and surgical approach. RESULTS: Nine patients presented with ocular symptoms and 1 patient had a temporal parenchymal hematoma. Angiograms showed that 5 DAVFs were located on the lesser wing of sphenoid bone, whereas the other 6 were on the greater wing of the sphenoid bone. Multiple branches of the ICA and ECA supplied the lesions in 7 patients. Four patients had cortical venous reflux and 7 patients had varices. Eight patients were treated with transarterial embolization using liquid embolic agents, while 3 patients were treated with transvenous embo- lization with coils or in combination with Onyx. Surgical disconnection of the cortical veins was performed in 2 patients with incompletely occluded DAVFs. Anatomic cure was achieved in all patients. Eight patients had angiographic and clinical follow-up and none had recurrence of their lesions. CONCLUSIONS: DAVFs may occur within the dura of the sphenoid wings and may often have a presentation similar to cavernous sinus DAVFs, but because of potential associations with the cerebral venous system, may pose a risk for intracranial hemorrhage.
    [Show full text]
  • CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit
    228 CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit MUSCLES OF FACIAL EXPRESSION Dural Venous Sinuses Not in the Subendocranial Occipitofrontalis Space More About the Epicranial Aponeurosis and the Cerebral Veins Subcutaneous Layer of the Scalp Emissary Veins Orbicularis Oculi CLINICAL SIGNIFICANCE OF EMISSARY VEINS Zygomaticus Major CAVERNOUS SINUS THROMBOSIS Orbicularis Oris Cranial Arachnoid and Pia Mentalis Vertebral Artery Within the Cranial Cavity Buccinator Internal Carotid Artery Within the Cranial Cavity Platysma Circle of Willis The Absence of Veins Accompanying the PAROTID GLAND Intracranial Parts of the Vertebral and Internal Carotid Arteries FACIAL ARTERY THE INTRACRANIAL PORTION OF THE TRANSVERSE FACIAL ARTERY TRIGEMINAL NERVE ( C.N. V) AND FACIAL VEIN MECKEL’S CAVE (CAVUM TRIGEMINALE) FACIAL NERVE ORBITAL CAVITY AND EYE EYELIDS Bony Orbit Conjunctival Sac Extraocular Fat and Fascia Eyelashes Anulus Tendineus and Compartmentalization of The Fibrous "Skeleton" of an Eyelid -- Composed the Superior Orbital Fissure of a Tarsus and an Orbital Septum Periorbita THE SKULL Muscles of the Oculomotor, Trochlear, and Development of the Neurocranium Abducens Somitomeres Cartilaginous Portion of the Neurocranium--the The Lateral, Superior, Inferior, and Medial Recti Cranial Base of the Eye Membranous Portion of the Neurocranium--Sides Superior Oblique and Top of the Braincase Levator Palpebrae Superioris SUTURAL FUSION, BOTH NORMAL AND OTHERWISE Inferior Oblique Development of the Face Actions and Functions of Extraocular Muscles Growth of Two Special Skull Structures--the Levator Palpebrae Superioris Mastoid Process and the Tympanic Bone Movements of the Eyeball Functions of the Recti and Obliques TEETH Ophthalmic Artery Ophthalmic Veins CRANIAL CAVITY Oculomotor Nerve – C.N. III Posterior Cranial Fossa CLINICAL CONSIDERATIONS Middle Cranial Fossa Trochlear Nerve – C.N.
    [Show full text]
  • Dural Venous Channels: Hidden in Plain Sight–Reassessment of an Under-Recognized Entity
    Published July 16, 2020 as 10.3174/ajnr.A6647 ORIGINAL RESEARCH INTERVENTIONAL Dural Venous Channels: Hidden in Plain Sight–Reassessment of an Under-Recognized Entity M. Shapiro, K. Srivatanakul, E. Raz, M. Litao, E. Nossek, and P.K. Nelson ABSTRACT BACKGROUND AND PURPOSE: Tentorial sinus venous channels within the tentorium cerebelli connecting various cerebellar and su- pratentorial veins, as well as the basal vein, to adjacent venous sinuses are a well-recognized entity. Also well-known are “dural lakes” at the vertex. However, the presence of similar channels in the supratentorial dura, serving as recipients of the Labbe, super- ficial temporal, and lateral and medial parieto-occipital veins, among others, appears to be underappreciated. Also under-recog- nized is the possible role of these channels in the angioarchitecture of certain high-grade dural fistulas. MATERIALS AND METHODS: A retrospective review of 100 consecutive angiographic studies was performed following identification of index cases to gather data on the angiographic and cross-sectional appearance, location, length, and other features. A review of 100 consecutive dural fistulas was also performed to identify those not directly involving a venous sinus. RESULTS: Supratentorial dural venous channels were found in 26% of angiograms. They have the same appearance as those in the tentorium cerebelli, a flattened, ovalized morphology owing to their course between 2 layers of the dura, in contradistinction to a rounded cross-section of cortical and bridging veins. They are best appreciated on angiography and volumetric postcontrast T1- weighted images. Ten dural fistulas not directly involving a venous sinus were identified, 6 tentorium cerebelli and 4 supratentorial.
    [Show full text]
  • Human and Nonhuman Primate Meninges Harbor Lymphatic Vessels
    SHORT REPORT Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI Martina Absinta1†, Seung-Kwon Ha1†, Govind Nair1, Pascal Sati1, Nicholas J Luciano1, Maryknoll Palisoc2, Antoine Louveau3, Kareem A Zaghloul4, Stefania Pittaluga2, Jonathan Kipnis3, Daniel S Reich1* 1Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, United States; 2Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, United States; 3Center for Brain Immunology and Glia, Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, United States; 4Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, United States Abstract Here, we report the existence of meningeal lymphatic vessels in human and nonhuman primates (common marmoset monkeys) and the feasibility of noninvasively imaging and mapping them in vivo with high-resolution, clinical MRI. On T2-FLAIR and T1-weighted black-blood imaging, lymphatic vessels enhance with gadobutrol, a gadolinium-based contrast agent with high propensity to extravasate across a permeable capillary endothelial barrier, but not with gadofosveset, a blood-pool contrast agent. The topography of these vessels, running alongside dural venous sinuses, recapitulates the meningeal lymphatic system of rodents. In primates, *For correspondence: meningeal
    [Show full text]
  • Treatment and Management of Venous Sinus Thrombosis
    Treatment and Management of Venous Sinus Thrombosis Sebastian Pollandt, MD Neurocritical Care/Epilepsy Rush University Medical Center 04/29/2016 Disclosures • No actual or potential conflict of interest in regards to this presentation • The planners, editors, faculty and reviewers of this activity have no relevant financial relationships to disclose. • This presentation was created without any commercial support. Learning Objectives At the conclusion of this course participants will be able to • Identify the epidemiology, pathophysiology and clinical features of cerebral venous sinus thrombosis (CVST) • Analyze diagnostic modalities of CVST • Evaluate principles of treatment of CVST Case • 35 year old healthy Female delivered a healthy infant via C-section • 3-4 days later, she developed headaches • Another 3 days later, friends found her confused on the floor with her baby next to her • Later in the day had a witnessed episode of generalized shaking Case • Head CT at OSH shows cerebral sinus venous thrombosis • Admitted, heparin drip started, transitioned to subcutaneous enoxaparin • Had several odd episodes of generalized shaking while maintaining consciousness • “Screaming in pain” with one of those episodes • Repeat head imaging showed progression of CVST thrombosis despite anticoagulation • Transfer to Rush • Extensive dural venous sinus thrombosis involving the entire superior sagittal sinus, right transverse and sigmoid sinuses • Partial thrombosis of the left transverse/sigmoid sinuses and several parasagittal cortical veins Case
    [Show full text]
  • The Development of Mammalian Dural Venous Sinuses with Especial Reference to the Post-Glenoid Vein
    J. Anat. (1967), 102, 1, pp. 33-56 33 With 12 figures Printed in Great Britian The development of mammalian dural venous sinuses with especial reference to the post-glenoid vein H. BUTLER Department ofAnatomy, University of Saskatchewan, Saskatoon, Canada The intracranial venous outflow of mammals drains into both the internal and external jugular veins and the relative role of these two veins varies between different adult mammals as well as at different phases of embryonic and foetal life. In general, the primary head vein (consisting of venae capitis medialis and lateralis and their tributaries) gives rise to the dural venous sinuses which drain into the anterior cardinal vein (the future internal jugular vein). The external jugular veins appear as the face and jaws develop but, at all times, the two venous systems freely com- municate with each other. Morphologically, as shown by Sutton (1888), both the dural venous sinuses and the external jugular venous system are extracranial in so far as they are situated outside the dura mater. The chondrocranium and the dermocranium, however, develop in between the dural venous sinuses and the external jugular vein system (Butler, 1957). Thus, in the adult mammal, the bony skull wall separates the two venous systems, and therefore the dural venous sinuses are topographically intracranial whereas the external jugular venous system is extracranial. Furthermore the development of the skull localizes the connexions between the dural venous sinuses and the external jugular venous system to the various fontanelles and neuro-vascular foramina to form the emissary veins. The post-glenoid vein is one of the more important and controversial emissary veins since its presence or absence has been used in attempts to establish mammalian phylogenetic relationships (van Gelderen, 1925; Boyd, 1930).
    [Show full text]
  • Dural Venous Sinuses Dr Nawal AL-Shannan Dural Venous Sinuses ( DVS )
    Dural venous sinuses Dr Nawal AL-Shannan Dural venous sinuses ( DVS ) - Spaces between the endosteal and meningeal layers of the dura Features: 1. Lined by endothelium 2. No musculare tissue in the walls of the sinuses 3. Valueless 4.Connected to diploic veins and scalp veins by emmissary veins .Function: receive blood from the brain via cerebral veins and CSF through arachnoid villi Classification: 15 venous sinuses Paried venous sinuses Unpaired venous sinuses ( lateral in position) • * superior sagittal sinus • * cavernous sinuses • * inferior sagittal sinus • * superior petrosal sinuses • * occipital sinus • * inferior petrosal sinuses • * anterior intercavernous • * transverse sinuses • sinus * sigmoid sinuses • * posterior intercavernous • * spheno-parietal sinuses • sinus • * middle meningeal veins • * basilar plexuses of vein SUPERIOR SAGITTAL SINUS • Begins in front at the frontal crest • ends behind at the internal occipital protuberance diliated to form confluence of sinuses and venous lacunae • • The superior sagittal sinus receives the following : • 1- Superior cerebral veins • 2- dipolic veins • 3- Emissary veins • 4- arachnoid granulation • 5- meningeal veins Clinical significance • Infection from scalp, nasal cavity & diploic tissue • septic thrombosis • CSF absorption intra cranial thrombosis (ICT) • Inferior sagittal sinus - small channel occupy • lower free magin of falx cerebri ( post 2/3) - runs backward and • joins great cerebral vein at free margin of tentorium cerebelli to form straight sinus. • - receives cerebral
    [Show full text]
  • The Routes of Intracranial Infections
    University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1934 The routes of intracranial infections E. Lloyd Wilbur University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Part of the Medical Education Commons Recommended Citation Wilbur, E. Lloyd, "The routes of intracranial infections" (1934). MD Theses. 364. https://digitalcommons.unmc.edu/mdtheses/364 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. THE ROUTES OF INTRACRANIAL INFECTIONS SENIOR THESIS 1934 E. Lloyd Wilbur April 13th, 1934 TABLE OF CONTENTS Section I Page Anatomical Considerations - - - - - - - - - - - - - - - 1 Section II The Routes of Infection - 31 Section III Case Histories -------------------- 40 Section IV SUmmary and Conclusions ---------------- 45 Bibliography --------------------- 50 PREFACE This thesis is written to discuss the anatomy of the skull and its contained structures in regard to intra­ oranial complioations due to preexisting routes. There is no attempt to discuss olinical medicine other than in a dir­ eot connection with these preexisting routes. In this way the dangerous potentialities of certain common infectious and pyogenio conditions may be more olearly understood and carefully watched for. To t~roughly comprehend these. dan­ gerous potentialities a knowledge of the anatomy of the skull and its ~ontents is essential. This thesis is written to mak~ this anatomy a basis of an understanding of certain types of intracranial pathology especially those arising as complications of previous pyogenic infeotious processes.
    [Show full text]
  • Investigating the Mechanical and Structural Properties of the Superior Sagittal Sinus
    IRC-20-64 IRCOBI conference 2020 Investigating the Mechanical and Structural Properties of the Superior Sagittal Sinus Darragh R. Walsh, Aisling M. Ross, David T. Newport, John J. E. Mulvihill Abstract The meninges, which are a composite tissue surrounding the brain, play an important role in the mechanopathology of traumatic brain injury. Studies have demonstrated that the meninges are pivotal in mitigating the damaging strains placed on the cortex from both physiological and pathophysiological head movement, which can occur during dynamic events such as traffic accidents. Conversely, structures such as the falx and tentorium have been shown to induce large deleterious strains within the brain. Understanding the mechanical behaviour of these tissues is important to predict computational model brain strains. This study provides the first biomechanical and structural evaluation of the structures anatomically tethered to the falx cerebri, the superior sagittal sinus. We utilise uniaxial tensile testing, digital image correlation analysis and scanning electron microscopy on porcine superior sagittal sinus tissue to show that these structures are mechanically stiffer (with elastic moduli ranging from 33 to 58 MPa) than the properties that are typically assigned to them in computational models of traumatic brain injury (elastic modulus of 31.5 MPa). This work has the potential to improve the biofidelity of traumatic brain injury finite element models, thus improving crash reconstruction and injury prediction efforts. Keywords Dura mater, finite element modelling, mechanical characterisation, TBI, venous sinuses. I. INTRODUCTION Traumatic brain injury (TBI) can be caused by rapid linear or rotational acceleration of the head experienced in vehicular collisions, explosions, falls, or assaults.
    [Show full text]
  • Superficial Middle Cerebral Vein SUPERFICIAL CORTICAL VEINS O Superior Cerebral Veins
    Cerebral Blood Circulation Khaleel Alyahya, PhD, MEd King Saud University School of Medicine @khaleelya OBJECTIVES At the end of the lecture, students should be able to: o List the cerebral arteries. o Describe the cerebral arterial supply regarding the origin, distribution and branches. o Describe the arterial Circle of Willis . o Describe the cerebral venous drainage and its termination. o Describe arterial & venous vascular disorders and their clinical manifestations. WATCH Review: THE BRAIN o Large mass of nervous tissue located in cranial cavity. o Has four major regions. Cerebrum (Cerebral hemispheres) Diencephalon: Thalamus, Hypothalamus, Subthalamus & Epithalamus Cerebellum Brainstem: Midbrain, Pons & Medulla oblongata Review: CEREBRUM o The largest part of the brain, and has two hemispheres. o The surface shows elevations called gyri, separated by depressions called sulci. o Each hemispheres divided into four lobes by deeper grooves. o Lobs are separated by deep grooves called fissures. Review: BLOOD VESSELS o Blood vessels are the part of the circulatory system that transports blood throughout the human body. o There are three major types of blood vessels: . Arteries, which carry the blood away from the heart. Capillaries, which enable the actual exchange of water and chemicals between the blood and the tissues. Veins, which carry blood from the capillaries back toward the heart. o The word vascular, meaning relating to the blood vessels, is derived from the Latin vas, meaning vessel. Avascular refers to being without (blood) vessels. Review: HISTOLOGY o The arteries and veins have three layers, but the middle layer is thicker in the arteries than it is in the veins: .
    [Show full text]
  • Powerpoint Handout: Lab 1, Part B: Dural Folds, Dural Sinuses, and Arterial Supply to Head and Neck
    PowerPoint Handout: Lab 1, Part B: Dural Folds, Dural Sinuses, and Arterial Supply to Head and Neck Slide Title Slide Number Slide Title Slide Number Arterial Blood Supply to the Head: Aortic Arch Branches Slide 2 Innervation of Dura Slide 14 Arterial Blood Supply to the Head: Carotid Arteries Slide 3 Emissary Veins & Diploic Veins Slide 15 Arterial Blood Supply to the Head: Internal Carotid Artery Slide4 Cerebral & Cerebellar Veins Slide 16 Blood Supply Review from MSI: Subclavian Artery & Named Dural Folds Slide 5 Slide 17 Thyrocervical Trunk Dural Venous Sinuses Slide 18 Vertebral Artery Slide 6 Dural Venous Sinuses (Continued) Slide 19 Subclavian Steal Syndrome Slide 7 Osseous Grooves formed by Dural Sinuses Slide 20 Thyrocervical Trunk Slide 8 Venous Drainage of Head: Cavernous Sinuses Slide 21 Review: Suprascapular Artery Slide 9 Head & Neck Venous Drainage Slide 22 Review: Transverse Cervical Artery Slide 10 Intracranial Versus EXtracranial Venous Drainage Slide 23 Middle Meningeal Artery Slide 11 Meningeal Layers & Spaces Slide 12 Cranial Dura, Dural Folds, & Dural Venous Sinuses Slide 13 Arterial Blood Supply to the Head: Aortic Arch Branches The head and neck receive their blood supply from https://3d4medic.al/PXGmbxEt branches of the right and left common carotid and right and left subclavian arteries. • On the right side, the subclavian and common carotid arteries arise from the brachiocephalic trunk. • On the left side, these two arteries originate from the arch of the aorta. Arterial Blood Supply to the Head: Carotid Arteries On each side of the neck, the common carotid arteries ascend in the neck to the upper border of the thyroid cartilage (vertebral level C3/C4) where they divide into eXternal and internal carotid arteries at the carotid bifurcation.
    [Show full text]
  • Lecture 4 Human Anatomy Second Stage احمد جسام النقيب د. the Meninges the Brain in the Skull Is Surro
    Lecture 4 Human Anatomy second stage د. احمد جسام النقيب The Meninges The brain in the skull is surrounded by three protective membranes, or meninges: the dura mater, the arachnoid mater, and the pia mater. (The spinal cord in the vertebral column is also surrounded by three meninges) Dura Mater of the Brain The dura mater is conventionally described as two layers: the endosteal layer and the meningeal layer. These are closely united except along certain lines, where they separate to form venous sinuses. The endosteal layer is nothing more than the ordinary periosteum covering the inner surface of the skull bones. It does not extend through the foramen magnum to become continuous with the dura mater of the spinal cord. Around the margins of all the foramina in the skull, it becomes continuous with the periosteum on the outside of the skull bones. At the sutures, it is continuous with the sutural ligaments. It is most strongly adherent to the bones over the base of the skull. The meningeal layer is the dura mater proper. It is a dense, strong, fibrous membrane covering the brain and is continuous through the foramen magnum with the dura mater of the spinal cord. It provides tubular sheaths for the cranial nerves as the latter pass through the foramina in the skull. Outside the skull, the sheaths fuse with the epineurium of the nerves. The meningeal layer sends inward four septa that divide the cranial cavity into freely communicating spaces lodging the subdivisions of the brain. The function of these septa is to restrict the rotatory displacement of the brain.
    [Show full text]