SPECIAL EMBRYOLOGY

( EMBRYOLOGIA SPECIALIS )

EMBRYOLOGY OF THE CENTRAL NERVOUS SYSTEM

Lecturer : Bernard SM Hutabarat, dr, PAK

This teaching material is copyrighted.

No part of this work may be reproduced, including photocopied, without written permission of Universitas Pelita Harapan .
 ROMAN 12 : 2 - 3

DO NOT BE CONFORMED TO THIS WORLD BUT BE

TRANSFORMED BY THE RENEWING OF YOUR MINDS, SO THAT
YOU MAY DISCERN WHAT IS THE WILL OF GOD – WHAT IS
GOOD AND ACCEPTABLE AND PERFECT
FOR BY THE GRACE GIVEN TO
ME I SAY TO EVERYONE AMONG
YOU NOT TO THINK OF YOURSELF
MORE HIGHLY THAN YOU OUGHT
TO THINK, BUT TO THINK WITH
SOBER , EACH ACCORDING TO
THE MEASURE OF FAITH THAT
GOD HAS ASSIGNED.

BRAIN
1/30/2024 7:00
PM 2
 LEARNING OBJECTIVE

STUDENTS ARE ABLE TO EXPLAIN EMBRYOLOGY AND THE

DEVELOPMENT OF:
1. CEREBRAL HEMISPHERES ( HEMISPHERIAE CEREBRALES ),
BRAIN STEM ( TRUNCUS ENCEPHALI ), CEREBELLUM AND
SPINAL CORD ( MEDULLA SPINALIS ).
2. THE BRAIN VENTRICLE SYSTEM ( SYSTEMAE VENTRICULARES
CEREBRALES ) AND SUBARACHNOID SPACE ( SPATIUM
SUBARACHNOIDEUM ).
3. CONGENITAL MALFORMATION OF CENTRAL NERVOUS SYSTEM

SKDI 2012:
AREA OF COMPETENTCY :5
LEVEL OF COMPETENTCY : 1 OR 2

1/30/2024 3
 DEVELOPMENT OF THE BRAIN

BRAIN IS ONE OF THE EARLIEST SYSTEM TO DEVELOP AND

THE LAST TO BE COMPLETED AFTER BIRTH.

CENTRAL NERVOUS SYSTEM APPEARS AT THE BEGINNING OF

THE 3RD WEEK AS A DERIVATIVE OF ECTODERMAL GERM
LAYER.
ORGANOGENESIS :
NEURAL TUBE

NEURAL FOLD

NEURAL PLATE

ECTODERM

1/30/2024 4
 DEVELOPMENT OF 3 BRAIN VESICLES

WEEK 4 : ELONGATION & ENLARGEMENTS OF NEURAL TUBE

FOREBRAIN
( PROSENCEPHALON )

MIDBRAIN
( MESENCEPHALON )
SPINAL CORD
( MEDULLA SPINALIS )
HINDBRAIN
( RHOMBENCEPHALON )
LATERAL VIEW

1/30/2024 5
 THE 5 BRAIN VESICLES

WEEK 5
LATERAL VIEW
LAMINA TERNINALIS
TELENCEPHALON

DIENCEPHALON

PROSENCEPHALON

MESENCEPHALON
PONS VAROLI
METENCEPHALON
CEREBELLUM
MYELENCEPHALON
MEDULLA OBLONGATA
RHOMBENCEPHALON
MEDULLA SPINALIS

1/30/2024 6
 FORMATION OF THE BRAIN VENTRICLE SYSTEM

LAMINA TERMINALIS
1. PROSENCEPHALON
1.1. TELENCEPHALON
( LATERAL VENTRICLES/
VENTRICULI LATERALES)
1.2. DIENCEPHALON
( 3RD VENTRICLE / VENTRIC.
TERTIUS )
2. MESENCEPHALON
(CEREBRAL AQUEDUCT /
AQUAEDUCTUS CEREBRI SYLVII )
3. RHOMBENCEPHALON
(4TH VENTRICLE/VENTR.QUARTUS)
EARLY
4 MONTHS
1/30/2024 7
 FORMATION OF MENINGES

MESENCHYME SURROUNDING NEURAL TUBE

CONDENSATED
PRIMITIVE MENINX ( MENINX PRIMITIVA )

PACHYMENINX LEPTOMENINX

DURA MATER ARACHNOID MATER PIA MATER

SUBDURAL SPACE / SPATIUM SUBDURALE

( BRIDGING VEINS )
SUBARACHNOID SPACE / SPATIUM SUBARACHNOIDEUM
( ARTERY & LCS )
 DEVELOPMENT OF SPINAL CORD

CONUS MEDULLARIS
( L 1,2 )

DEVELOPED CRANIALLY

FILUM TERMINALE

S1
SPINE & DURAMATER GROW RAPIDLY THAN THE
SPINAL CORD
 CONGENITAL MALFORMATION
( MALFORMATIO CONGENITALIA )
FAILURE OF THE NEURAL TUBE CLOSURE
1. ANENCEPHALI
- NEUROPORUS ANTERIOR FAILED TO CLOSE
- FREQUENCY = 1 : 1000 , : = 4 : 1
- CALVARIA, SCALP & MAJOR PORTION OF THE
BRAIN ABSENT.
- EYES BULGED FORWARD ; NECK ABSENT
- CRANIOSCHIZIS : DEFECT INVOLVING SKULL
2. DEFECT OF SKULL BONE OSSIFICATION
- MOST AFFECTED : OCCIPITAL SQUAMOUS BONE
- MANIFESTED AS
-- MENINGOCELE
-- MENINGO-ENCEPHALOCELE
-- MENINGO-HYDRO-ENCEPHALOCELE
FAILURE OF THE NEURAL TUBE CLOSURE

3. SPINA BIFIDA
- DORSAL PORTIONS OF VERTEBRAE
FAILED TO FUSE.
- LOCATION : SACROLUMBAR
- COVERED BY SKIN, NOT
NOTICABLE ON THE SURFACE
EXCEPT THE PRESENCE OF
A SMALL TUFT OF HAIR OVER
THE AFFECTED AREA
( SPINA BIFIDA OCCULTA )
 FAILURE OF NEURAL TUBE CLOSURE

4. > 1 VERTEBRA INVOLVED

HAIR DURAMATER ARACHNOID MATER

SUBARACHNOID
SPACE

4.1.SPINA BIFIDA OCCULTA 4.2. MENINGOCELE

4.3. MENINGOMYELOCELE
 FAILURE OF NEURAL TUBE CLOSURE

RACHISCHIZIS ( GR : RACH = SPINE ; SCHIZIS = SPLIT ) : SEVERE

FORM OF SPINA BIFIDA ( COMPLETE SPINA BIFIDA ) : CERVICAL
TO SACRUM.
FOLDED NEURAL TISSUE
 MALFORMATION OF VENTRICULAR SYSTEM

4. HYDROCEPHALUS : CSF ( LCS ) VOLUME > NORMAL (± 90–150 CC)

SIZE OF HEAD > NORMALLY

MECHANISM:
1. EXCESSIVE PRODUCTION
2. OBSTRUCTION OF FLOWS
3. ABSORBTION DISTURBANCE
CONSISTS OF :
1. HYDROCEPHALUS EXTERNA
2. HYDROCEPHALUS INTERNA
3. HYDROCEPHALUS COMMUNICANS
 CONGENITAL MALFORMATION OF THE SPINAL CORD

NORMAL DEVELOPMENT

* NEURAL TUBE IMPROPER

GROWTH
NEURAL (TUBE
SPINAIMPROPER
BIFIDA )
* TISSUE ATTACHMENT
GROWTH ( SPINA BIFIDA )
* THICKENED FILUM TERMINALE
* TISSUE ATTACHMENT
* THICKENED FILUM TERMINALE

TETHERED CORD
 REFERENCES
1. anatomystudentforum.blogspot.com
2. INDIANA UNIVERSITY SCHOOL OF MEDICINE :
THE DEVELOPING HUMAN
3. LANGMAN, JAN :MEDICAL EMBRYOLOGY
4. MARINO, THOMAS A : DEVELOPMENT OF THE
BRAIN AND SPINAL CORD
5. php.med.unsw.edu.au
6. FEDERATIVE INTERNATIONAL PROGRAMME ON ANATOMICAL
TERMINOLOGIES ( FIFAT ), 2ND EDIT. : TERMINOLGIA ANATOMICA
7. UNSW : EMBRYOLOGY