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Ventricles of Brain & THE VENTRICULAR SYSTEM By L. S. K OUTLINE • INTRODUCTION • LATERAL VENTRICULES INTERVENTRICULAR FORMEN • 3RD VENTRICLE CEREBRAL AQUEDUCT • 4TH VENTRICLE • SUBARACHNOID SPACE AND CISTERNS • CLINICAL CORRELATES INTRODUCTION THE CAVITIES/VENTRICLES • Ventricles are four fluid filled cavities located with in the brain. These are : Two lateral ventricles. Third ventricle. Fourth ventricle. COMMUNICATIONS OF THE VENTRICULAR SYSTEM The central canal in the spinal cord has a small dilatation at its inferior end, referred to as the terminal ventricle. LINING & CONTENT The ventricles are lined by an epithelial layer known as ependyma & are filled with cerebrospinal fluid. The ventricles are developmentally derived from the cavity of the neural tube. Development of the ventricles LATERAL VENTRICLE These are two irregular cavities situated one in each cerebral hemisphere Each lateral ventricle consists of: a central part Three horns, anterior, posterior and inferior THE CENTRAL PART This part of lateral ventricle extends from the interventricular foramen in front to the splenium of the corpus callosum behind. BOUNDARIES ROOF : formed by undersurface of corpus callosum FLOOR : formed (from lateral to medial side) by: a. Body of caudate nucleus b. Stria terminalis c. Thalamostriate vein d. Lateral portion of upper surface of thalamus e. Choroid plexuse and the lateral part of the fornix MEDIAL WALL Anteriorly Formed by- septum pellucidum and body of fornix. Posteriorly the roof & the floor come together on the medial wall. THE ANTERIOR HORN This part lies in front of interventricular foramen and extends into frontal lobe. It is directed forwards, laterally and downwards BOUNDARIES ANTERIOR : Posterior surface of genu and rostrum of corpus callosum ROOF : Undersurface of Anterior part of trunk of corpus callosum FLOOR : a. Head of the caudate nucleus b. Upper surface of the rostrum of the corpus callosum • MEDIAL : a. Septum pellucidum b. Anterior Column of fornix THE POSTERIOR HORN This part lies behind the splenium of corpus callosum and extends into occipital lobe. It is directed backwards and medially BOUNDARIES FLOOR & MEDIAL WALL : shows 2 elevations a) Superior swelling,Bulb of posterior horn caused by forceps major b) Inferior swelling,Calcar avis caused by anterior part of calcarine sulcus ROOF & LATERAL WALL : Tapetum of corpus callosum, lateral to which are fibers of optic radiation THE INFERIOR HORN Largest horn of lateral ventricle. It begins at the junction of the central part with the posterior horn of lateral ventricle; and extends into the temporal lobe BOUNDARIES ROOF ( & LATERAL WALL) : a) Chiefly by the inferior surface of the tapetum of corpus callosum b) Tail of caudate nucleus c) Stria terminalis THE INFERIOR HORN FLOOR : Laterally by Collateral eminence caused by collateral sulcus/fissures Hippocampus medially In the inferior horn, the line of ependymal invagination by the choroid plexus ( i.e. the choroid fissure ) lies b/w the stria terminalis and the fimbria. CHOROID PLEXUS OF THE LATERAL VENTRICLES Project into the ventricles on its medial aspect It is a vascular fringe composed of pia matter covered with ependyma lining of the ventricular cavity. Within each lateral edge of the tela choroidea (A 2 layered fold of pia mater, the tela choroidea, invaginates through the fissure & covers part of the thalamus) there are plexuses of blood vessels that constitute choroid plexus . Function to produce CSF. Choroid fissure A space between fornix and upper surface of the thalamus A line along which choroid plexus invaginates into lateral ventricle It’s a c- shaped slit in medial wall of cerebral hemisphere Starts at interventricular foramen (above and in front) & passes around the thalamus Thus it is present only in relation to the central part and inferior horn of the lateral ventricle Its convex margin is bounded by fornix (body and crus),and concave margin is bounded by the thalamus (superior and posterior surfaces), the tail of the caudate nucleus and the stria terminalis. THIRD VENTRICLE. Is a median cleft between the two thalami. Developmentally, it represents the cavity of diencephalon The cavity is lined by ependyma COMMUNICATIONS Anterosuperiorly, on each side, it communicates with the lateral ventricle through the interventricular foramen (or foramen of monro) This foramen is bounded anteriorly by the column of fornix, and posteriorly by the tubercle of the thalamus. Posteroinferiorly, in the median plane, it communicates with the fourth ventricle through the cerebral aqueduct. RECESSES Recesses are extensions of the cavity. These are: Optic recess Infundibular recess Pineal recess Suprapineal recess. BOUNDARIES ANTERIOR WALL : 1) Lamina terminalis 2) Anterior commissure 3) Anterior columns of fornix POSTERIOR WALL : 1) Pineal recess. 2) Posterior commissure (in the lower lamina of pineal stalk) 3) Cerebral aqueduct ROOF/superioir wall : It is formed by the ependyma lining, the under surface of the tela choroidea of the third ventricle The choroid plexus of the third ventricle projects downwards from the roof Related superiorly to the fornix & the corpus callosum FLOOR/inferior wall : formed by hypothalamic structures- Optic chiasma Tubercinerium Infundibulum (pitiutary stalk) Mammilary bodies Posterior to these structures is Tegmentum of the midbrain LATERAL WALL : 1) Medial surface of thalamus (in its posterosuperior wall) 2) Medial surface of Hypothalamus (in its anteroinferior part) 3) The hypothalamus sulcus which separates the thalamus from the hypothalamus. The sulcus extends from the interventricular foramen to the cerebral aqueduct 4) Limited superiorly by stria medularis thalami 5) They are joined by the interthalamic connection. TELA CHOROIDEA OF THE THIRD AND LATERAL VENTRICLES Its a double layered fold of piamater that occupies the interval b/w splenium of corpus callosum and fornix, above, & the two thalami below. It is triangular in shape Its posterior end is broad & lies in the gap b/w the splenium (above) & posterior part of the roof of the third ventricle (below) The anterior end (representing the apex of triangle) lies near the left & right interventricular foramina The median part of the tela choroidea lies on the roof of third ventricle Its right & left lateral edges project into the central parts of the corresponding lateral ventricles. CHOROID PLEXUSES Highly vascular structures that are responsible for formation of CSF Surface of each plexus is lined by a membrane formed by fusion of ventricular ependyma with pia mater of tela choroidea. Deep to this membrane there is plexus of blood vessels . Microscopically, surface of choroid plexus has numerous villous processes. The blood supply of tela chroidea and choroid plexuses of lateral & third ventricle is derived from choroidal branches of internal carotid and basilar arteries. The venous blood drains in to the internal cerebral veins, which unite to form the great cerebral vein. 4 choroid plexuses are seen in relation to the tela choroidea of third and lateral ventricles. Two of these (one right & one left) lie along the corresponding lateral margins; & project into central part of corresponding lateral ventricle. Two other plexuses run parallel to each other, one on either side of midline. These are choroid plexuses of third ventricle. At each posterolateral angle of tela choroidea the choroid plexus of lateral ventricle continues into inferior horn. CEREBRAL AQUEDUCT The cerebral aqueduct( aqueduct of sylvius), a narrow channel about ¾ of an inch long, connects the third ventricle with forth ventricle. It is lined with ependyma and is sorrounded by a layer of gray matter called the central grey. There is no choroid plexus in the cerebral aqueduct. FOURTH VENTRICLE • The fourth ventricle is a tent shaped cavity filled with cerebrospinal fluid. It is situated anterior to the cerebellum and posterior to the pons and medulla oblongta. • It is lined with ependyma and is continuous above with cerebral aqueduct of midbrain & below with central canal of medulla oblongta and spinal cord. • The fourth ventricle posssess lateral boundaries , a roof , and a rhomboid shaped floor. Lateral boundaries The caudal part of each lateral boundary is formed by the inferior cerebellar peduncle. The cranial part of each lateral boundary is formed by superior cerebellar peduncle. Roof / Posterior wall The tent shaped roof projects in to the cerebellum. The superior part of the roof is formed by superior medullary velum and inferior part by inferior medullary velum. This part of the roof is peirced in the midline by a large aperture(median aperture of foramen of magendie). Lateral recesses extend laterally around the sides of the medulla and open anteriorly as the lateral openings of the fourth ventricle or foramen of luschka. POSTERIOR VIEW OF CAVITY OF FOURTH VENTRICLE POSTERIOR VIEW OF FLOOR OF FOURTH VENTRICLE Floor / Rhomboid fossa • The diamond shaped floor is formed by the posterior surface of the pons & medulla oblongta. The floor is divided in to symetrical halves by the median sulcus. • On each side of sulcus, there is an elevation , the medial eminence which is bounded laterally by another sulcus, the sulcus limitans. • Lateral to this sulcus limitans, there is a vestibular area & vestibular nuclei lies behind it. • The facial colliculus is a slight swelling at the inferior end of the medial eminence that is produced by the fibres from the motor nucleus of the facial nerve. • Superior end of the sulcus limitans possesses
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