Meninges and Venous Sinuses of Brain Fact
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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. -
Gross Anatomy
www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY www.BookOfLinks.com Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the infor- mation contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY David A. Morton, PhD Associate Professor Anatomy Director Department of Neurobiology and Anatomy University of Utah School of Medicine Salt Lake City, Utah K. Bo Foreman, PhD, PT Assistant Professor Anatomy Director University of Utah College of Health Salt Lake City, Utah Kurt H. -
Dynamic Assessment of Venous Anatomy and Function in Neurosurgery with Real-Time Intraoperative Multimodal Ultrasound: Technical Note
NEUROSURGICAL FOCUS Neurosurg Focus 45 (1):E6, 2018 Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note Francesco Prada, MD,1,2 Massimiliano Del Bene, MD,1,3 Giovanni Mauri, MD,4 Massimo Lamperti, MD,5 Davide Vailati, MD,6 Carla Richetta, MD,7 Marco Saini, MD,1 Davide Santuari, MD,8 M. Yashar S. Kalani, MD, PhD,2 and Francesco DiMeco, MD1,9 1Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy; 2Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, Virginia; Departments of 3Experimental Oncology and 4Radiology, European Institute of Oncology, Milan, Italy; 5Anesthesiology Unit, Cleveland Clinic, Abu Dhabi, United Arab Emirates; 6Anesthesiology Unit, Ospedale di Circolo di Melegnano, Presidio di Vizzolo Predabissi, Milan, Italy; 7Department of Neurosurgery, Sourasky Medical Center, Tel Aviv, Israel; 8Department of Vascular Surgery, Ospedale S. Carlo, Milan, Italy; and 9Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, Maryland The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins. Intraoperative ultrasound (ioUS) permits the real-time study of venous compartments using different modalities, thus allowing complete characterization of their anatomical and functional features. The B-mode (brightness mode) offers a high-resolution anatomical representation of veins and their relationships with lesions. Doppler modalities (color, power, spectral) allow the study of blood flow and identification of vessels to distinguish their functional characteristics. -
The Development of the Epidural Space in Human Embryos
Folia Morphol. Vol. 63, No. 3, pp. 273–279 Copyright © 2004 Via Medica O R I G I N A L A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl The development of the epidural space in human embryos Magdalena Patelska-Banaszewska, Witold Woźniak Department of Anatomy, University School of Medical Sciences, Poznań, Poland [Received 25 April 2004; Accepted 25 June 2004] The epidural space is seen in embryos at stage 17 (41 days) on the periphery of the primary meninx. During stage 18 (44 days) the dura mater proper appears and the epidural space is located between this meninx and the perichondrium and contains blood vessels. During the last week of the embryonic period (stages 20–23) the epidural space is evident around the circumference of the spinal cord. On the posterior surface it is found between the dura mater and the me- soderm of the dorsal body wall. Key words: human neuroembryology, primary meninx, epidural space INTRODUCTION horizontal, frontal, and sagittal planes and stained The epidural space lies between the spinal dura according to various methods (chiefly Mallory, hae- mater and the periosteum of the vertebral canal. This matoxylin and eosin and with silver salts). In some periosteum is formed by the outer endosteal layer embryos graphic reconstructions were prepared at of the dura mater. The epidural space contains loose each of the stages investigated. connective tissue, venous plexuses and adipose tis- sue, which is particularly evident in the lumbar re- RESULTS gion [8]. There is some evidence that it is only a po- The primordium of the epidural space appears in tential space [2]. -
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. -
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. -
Spinal Meninges Neuroscience Fundamentals > Regional Neuroscience > Regional Neuroscience
Spinal Meninges Neuroscience Fundamentals > Regional Neuroscience > Regional Neuroscience SPINAL MENINGES GENERAL ANATOMY Meningeal Layers From outside to inside • Dura mater • Arachnoid mater • Pia mater Meningeal spaces From outside to inside • Epidural (above the dura) - See: epidural hematoma and spinal cord compression from epidural abscess • Subdural (below the dura) - See: subdural hematoma • Subarachnoid (below the arachnoid mater) - See: subarachnoid hemorrhage Spinal canal Key Anatomy • Vertebral body (anteriorly) • Vertebral arch (posteriorly). • Vertebral foramen within the vertebral arch. MENINGEAL LAYERS 1 / 4 • Dura mater forms a thick ring within the spinal canal. • The dural root sheath (aka dural root sleeve) is the dural investment that follows nerve roots into the intervertebral foramen. • The arachnoid mater runs underneath the dura (we lose sight of it under the dural root sheath). • The pia mater directly adheres to the spinal cord and nerve roots, and so it takes the shape of those structures. MENINGEAL SPACES • The epidural space forms external to the dura mater, internal to the vertebral foramen. • The subdural space lies between the dura and arachnoid mater layers. • The subarachnoid space lies between the arachnoid and pia mater layers. CRANIAL VS SPINAL MENINGES  Cranial Meninges • Epidural is a potential space, so it's not a typical disease site unless in the setting of high pressure middle meningeal artery rupture or from traumatic defect. • Subdural is a potential space but bridging veins (those that pass from the subarachnoid space into the dural venous sinuses) can tear, so it is a common site of hematoma. • Subarachnoid space is an actual space and is a site of hemorrhage and infection, for example. -
The Meninges and Common Pathology Understanding the Anatomy Can Lead to Prompt Identification of Serious Pathology
education The meninges and common pathology Understanding the anatomy can lead to prompt identification of serious pathology The meninges are three membranous of the skull and extends into folds that arterial blood has sufficient pressure to layers that surround the structures of the compartmentalise the skull.1 2 The large separate the dura from the bare bone of central nervous system. They include the midline fold separates the two hemispheres the skull.4 The classic example of this is dura mater, the arachnoid mater, and and is called the falx.1 A smaller fold a severe blow to the temple that ruptures the pia mater. Together they cushion the separates the cerebral hemispheres from the middle meningeal artery, which brain and spinal cord with cerebrospinal the cerebellum and is known as the has part of its course between the skull fluid and support the associated vascular tentorium cerebelli usually abbreviated as and the dura at a weak point called the structures.1 2 Although they are usually “tentorium” (fig 1).1‑3 pterion.1 2 4 This creates an extradural mentioned as a trio, there are subtle but Where the edges of the falx and tentorium haematoma,2 a potentially lifethreatening important differences to the arrangement of meet the skull, the dura encloses large injury that classically presents with the meninges in the spine and cranium. The venous sinuses that are responsible for decreased consciousness and vomiting aim of this introduction to the meninges is draining venous blood from the brain.1 4 after a lucid interval (an initial period of to clarify the anatomy and link these details These are not to be confused with the air apparently normal consciousness). -
Anatomic Comparison of Veins of Labbé Between Autopsy, Digital Subtraction Angiography and Computed Tomographic Venography
Fang et al. BioMed Eng OnLine (2017) 16:84 DOI 10.1186/s12938-017-0374-3 BioMedical Engineering OnLine RESEARCH Open Access Anatomic comparison of veins of Labbé between autopsy, digital subtraction angiography and computed tomographic venography Qiong Fang1, Anhong Jiang2, Wei Tao3* and Lin Xin4 *Correspondence: [email protected] Abstract 3 Department of Anatomy, Objective: The drainage portion of the vein of Labbé varies, and it is difcult to pre- School of Medicine, Anhui University of Science & dict whether the operation is likely to damage this vein. The aim of this study was to Technology, 25 Dongshan correlate the microanatomy of the vein of Labbé with digital subtraction angiography Road, Huainan 232001, China (DSA) and computed tomographic venography (CTV), in order to provide a basis for Full list of author information is available at the end of the the preservation of the vein of Labbé during a supratentorial surgical approach. article Methods: A total of 30 human cadavers (60 sides) and 61 living patients (110 sides) were examined in this study. Each cadaver head was injected with blue latex via the superior sagittal sinus and the internal jugular veins. The venograms of each patient were obtained from the venous phases of DSA (60 sides for 36 patients) or CTV (50 sides for 25 patients). Results: The patients were divided into four subgroups based on the location where a vein entered the dural sinus: the transverse sinus group, the tentorial group, the petrosal group, and the upper-transverse sinus group. The veins of Labbé in transverse sinus group and petrosal group directly entered dural sinus. -
Anatomical Aspects of Epidural and Spinal Analgesia
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Via Medica Journals Review paper Grzegorz Jagla1, 2, Jerzy Walocha2, K. Rajda3, Jan Dobrogowski4, Jerzy Wordliczek1 1Department of Pain Treatment and Palliative Care Medical College, Jagiellonian University, Krakow, Poland 2Department of Anatomy Medical College, Jagiellonian University, Krakow, Poland 31st Department of Internal Medicine, J. Dietl Hospital, Krakow, Poland 4Department of Pain Research and Treatment, Medical College, Jagiellonian University, Krakow, Poland Anatomical aspects of epidural and spinal analgesia Abstract Regional anaesthesia seems to be the future of the anaesthesia in this century. The knowledge of the anatomy of the epidural and other spinal spaces seems to play the crucial role in success of regional anaesthesia. It's important in perioperative medicine and cancer pain treatment. Up to date there is not too many datas considering anatomy of these compartments. Many of the results obtained by research- ers in the past are still not mentioned in the clinical textbooks. This article is an attempt to resolve this problem. Key words: epidural anesthesia, spinal anesthesia, human anatomy, epidural space Adv. Pall. Med. 2009; 8, 4: 135–146 Introduction nal lamina of the dura mater, and the dural sac which consists of the internal lamina of dura mater Successful a hinges on successfully reaching neu- and arachnoid. Many fragments of this space are ral tissue. The sensation of pain traveling from noci- empty (they contain only air). It can be found in all ceptor to sensory cortex follows an elaborate and places where the dural sac reaches the vertebral complex path before being registered by our brains: pedicles, vertebral lamina or ligamentum flava. -
Structural and Mechanical Characterisation of Bridging Veins: a Review
Structural and mechanical characterisation of bridging veins: a review Nele Famaeya,∗, Zhao Ying Cuia,∗, Grace Umuhire Musigazib, Jan Ivensc, Bart Depreitereb, Erik Verbekend, Jos Vander Slotena aBiomechanics Section, KU Leuven, Belgium bDepartment of Neurosurgery, University Hospital Gasthuisberg, KU Leuven, Belgium cComposite Materials Group, Department of Metallurgy and Materials Engineering, KU Leuven, Belgium dTranslational Cell & Tissue Research, KU Leuven, Belgium Abstract Bridging veins drain the venous blood from the cerebral cortex into the supe- rior sagittal sinus (SSS) and doing so they bridge the subdural space. Despite their importance in head impact biomechanics, little is known about their properties with respect to histology, morphology and mechanical behaviour. Knowledge of these characteristics is essential for creating a biofidelic finite element model to study the biomechanics of head impact, ultimately leading to the improved design of protective devices by setting up tolerance criteria. This paper presents a comprehensive review of the state-of-the-art knowledge on bridging veins. Tolerance criteria to prevent head injury through impact have been set by a number of research groups, either directly through impact experiments or by means of finite element (FE) simulations. Current state-of-the-art FE head models still lack a biofidelic representation of the bridging veins. To achieve this, a thorough insight into their nature and behaviour is re- quired. Therefore, an overview of the general morphology and histology is provided here, showing the clearly heterogeneous nature of the bridging vein complex, with its three different layers and distinct morphological and histo- logical changes at the region of outflow into the superior sagittal sinus. -
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