THE MENINGES

DEVELOPMENT
- developed from the cells of the neural crest &
mesenchyme (mesoderm) forming the
primitive meninges
- differentiate into ectomeninx (outer more
compact layer) & endomeninx (inner more
reticulated layer)
- ectomeninx becomes more compact and with
spaces (future sinuses) dura mater
(pachymeninx);
20-35 days of gestation endomeninx becomes more reticulated with
development of spaces (future SAS &
cisterns) arachnoid & pia mater
(leptomeninges)
- by the end of the first trimester, the meninges
cover over the entire brain & spinal cord
- ectomeninx around the brain is continuous
34-48 days of gestation
with the skeletal layer forming the skull but in
the spinal column as it develops, it
dissociates from the vertebral column;
epidural space
45- 60 days of gestation
MENINGES
• Protect the underlying brain and spinal cord
• Serve as support framework for important
arteries, veins, and sinuses
• Enclose a fluid-filled cavity, the subarachnoid
space, which is vital to the survival and normal
function of the brain and spinal cord
* Brain loses about 97% of its weight when suspended in CSF e.g.
1400 g in air will weigh only about 45-50 g in fluid*
Meninges
DURA MATER BLOOD & NERVE SUPPLY

CRANIAL BLOOD SUPPLY FORAMEN NERVE SUPPLY A N S

FOSSA
- ethmoidal aa - ethmoidal f. - ethmoidal n. -superior cervical
-ascending - ant. foramen - brs maxillary & ganglia
ANTERIOR pharyngeal aa. lacerum mandibular n.

-middle meningeal a - f. spinosum - brs of maxillary & -superior cervical

- acc. meningeal a. - f. ovale mandibular n. ganglia
MIDDLE - lacrimal a. - sup. orbital
fissure
- meningeal br of asc. - condylar canal -Sensory br. From -superior cervical
pharyngeal a. (inconstant) dorsal root of C1, ganglia
POSTERIOR - br of occipital & C2 & C3
vertebral aa. - mastoid f. - vagus n
- tentorial n
-aa. of vertebral, - Intervertebral f. -recurrent br of -superior cervical
intercostal & the spinal nerve ganglia
SPINAL lumbosacral
Dural Infolding & Sinuses
• Dural Infolding
– Falx cerebri - SSS,Straight S
– Falx cerebelli – Occipital sinus
– Tentorium cerebelli – Transverse sinus
– Diaphragma sellae – Intercavernous sinuses
• Dural Sinuses
– Unpaired:
• Superior Sagittal Sinus,
• Inferior Sagittal sinus
• Straight sinus,
• Occipital sinus
Paired:
• Transverse sinus
• Cavernous sinuses
• Sigmoid sinuses
• Petrosal sinuses
• Sphenoparietal sinuses
Dural Infolding & Sinuses
Dural Infolding & Sinuses

(Smallest of the dural

infolding)
Cavernous sinuses
- ant. & post.
intercavernous
sinuses

Tentorial
notch
COMPARTMENTS & HERNIATION SYNDROMES

FALX
CEREBRI

5-UPWARD HERNIATION
ARACHNOID VILLI
or arachnoid granulation
or pacchionian bodies

Arachnoid cap cells

Meningotheliomatous (syncytial)
meningioma

Transitional meningioma

Fibroblastic meningioma (fibrous)

Epidural Hematoma
Subdural Hematoma
Subdural Hygroma
PIA MATER
• Pia + arachnoid constitute the leptomeninges
• Very closely adherent to the brain surfaces
• Vessels penetrate the brain and bring along
with it a small envelope of pial cell processes
and extracellular space known as the
perivascular spaces (Virchow-Robin spaces)
• The spinal cord is anchored by 3 pial
structures: denticulate ligaments, filum
terminale internum, filum terminale externum
Contains CSF, vessels,
cranial nerve roots
Cisternal puncture
Subarachnoid hemorrhage
Meningitis
 CSF Findings in Various CNS Disorders

DISORDER PRESSURE APPEARANCE GLUCOSE PROTEIN CELLS

Acute
Pyogenic increased cloudy/turbid decreased increased Inc. PMNs

Chronic
TB, Fungal, increased Clear or cloudy decreased increased inc. lymphos
Part.Tx M
Acute Normal or Mildly
Viral Mildly inc. Clear, colorless normal increased Inc.
lymphos
SAH Bloody, does not Plenty of
increased clot, super- normal increased rbcs
natant xantho.
Traumatic Bloody, clots 4 mg inc. Same as
tap normal spontaneously, normal per 5000 peripheral
No xantho. rbc count