The Meninges and Blood Vessels of

Brain and Spinal Cord,

and the Cerebrospinal Fluid

Muh. Iqbal Basri

Anatomy Department
The Meninges of Brain and Spinal Cord

 The spinal cord and brain are

surrounded by three membranes,
the meninges. Named from the
outside inward they are the dura
mater, arachnoid, and pia mater.
 The meninges of spinal cord
 Spinal dura mater
 Spinal arachnoid mater
 Spinal pia mater
 Spinal dura mater
Characters
 Above, attached to
circumference of foramen
magnum
 Below, becomes thinner at
level of S2, invests filum
terminale to attach at back
of coccyx
Epidural space
 Position: lies between spinal dura mater and periosteum of vertebral canal
 Contents: a quantity of loose connective tissue, fat, lymphatic vessels and
vertebral venous plexus, the spinal nerves on each side pass through the
epidural space which is applicable for block anesthesia
Subdural space
 Spinal arachnoid mater
Characters
 A thin, delicate, tubular
membran loosely investing
spinal cord
 Above, it is continuous with
cerebral arachnoid mater
Subarachnoid space
 Position: lies between pia
and arachnoid maters
containing cerebrospinal
fluid
 Terminal cistern : the
largest part of subarachnoid
space extending from
termination of spinal cord to
level of S2, where it is
occupied by nerves of
cauda equina, so it is the
best site for a lumbar
puncture
Lumbar spinal puncture (spinal tap)
 Spinal pia mater
 A delicate vascular membrane
that closely invests the spinal
cord
 Denticulate ligament: consist
of 21 pairs triangular
ligaments extending from
spinal cord on each side
between anterior and posterior
roots of spinal nerves to
spinal dura mate; these
ligaments help to fix position
of spinal cord.
 Filum terminale: an
extension of pia beyond conus
medullaris
 The Meninges of Brain

 Cerebral dural mater

 Cerebral arachnoid mater
 Cerebral pia mater
 Cerebral dural mater
Characters
 A thick and dense
inelastic membrane that
composed of two layers,
an inner or meningeal
and outer or endosteal
 It is in loose contact with
calvaria, and most
strongly adherent to
base of skull
Four septa
 Cerebral falx
 Tentorium of cerebellum － in front there is a gap, the
tentorial incisure, for passage of midbrain
 Cerebellar falx
 Diaphragma sellae
Sinuses of duramater
 Superior sagittal sinus
 Inferior sagittal sinus
 Straight sinus
 Confluence of sinus
 Transverse sinus
 Sigmoid sinus
 Superior petrosal
sinuses
 inferior petrosal
sinuses
Cavernous sinus
 Position: lies on each side of sella turcica

 Relations of cavernous sinus:

 Internal carotid artery and abducent nerve run through the sinus
 Oculomotor and trochlear nerves and ophthalmic and maxillary
divisions of trigeminal nerve lie in the lateral wall of the sinus
 The flowing of the blood in dural sinus

Sup. sagittal sinus

Inf. sagittal sinus Straight sinus Confluence of sinus Transverse sinus

Sup. petrosal sinus

Sigmoid sinus
Cavernous sinus

Inf. petrosal sinus Internal jugular vein

Cerebral arachnoid mater
 Characters: a delicate
membrane covering
brain loosely, passing
over sulci and entering
only cerebral
longitudinal and
transverse fissures
 Arachnoid granulations － project into sinuses of dura mater,
serve as sites where cerebrospinal fluid diffuses into bloodstream
 Subarachnoid cisterns
 Cerebellomedullary
cistern
 Interpeduncular cistern
 Pontine cistern
 Superior cistern
Cerebellomedullary cistern
 Cerebral pia mater
 Closely invests brain
surface, in some areas the
pia invaginates into
ventricles to take part in
the formation of choroids
plexus
Circulation of cerebrospinal fluid
(CSF)
 Cerebrospinal fluid is a
clear colorless fluid, which
acts as a transport medium
for nutrients and vaster
products and provides a
protective fluid cushion for
the central nervous system.
 Production: produced by the
choroids plexuses within the
lateral, third and fourth
ventricles
 Circulation of cerebrospinal fluid
CSF drains from lateral ventricle interventricular foramina third ventricle

mesencephalic aqueduct median and two lateral apertures

fourth ventricle

subarachnoid space arachnoid granulations superior sagittal sinus vein

Blood vessels of brain and spinal cord
 Arteries of brain
Two sources
 Internal carotid
artery: supplies
anterior 2/3 of cerebral
hemisphere and parts
of diencephalon
 Vertebral artery:
supplies postterior 1/3
of cerebral
hemisphere and parts
of diencephalon, brain
stem and cerebellum
 Internal carotid artery
 Anterior cerebral artery
 Middle cerebral artery
 Anterior choroidal artery
 Posterior communicating
artery
Anterior cerebral artery
 Joined the fellow of the
opposite side by the
anterior communicating
artery
 Cortical branches: supply
all medial surface of the
cerebral cortex as far back
as the parietooccipital sulcus
and superior border of the
suprolateral surface of the
cerebral hemisphere
 Central branches: supply
caudate nucleus, anterior
part of lentiform nucleus and
anterior limb of internal
capsule
Middle cerebral artery
 Cortical branches:
supply most of
superolateral surface of
cerebral hemisphere and
insular lobe
 Central branches:
supply lentiform and
caudate nuclei, genu and
posterior limb of internal
capsule (lenticulostriate
artery)
 Anterior choroidal artery:
passes backward, enters
inferior horn of lateral ventricle,
and ends in choroid plexus. It
supplies lateral geniculate
body, posterior limb of internal
capsule, middle 3/5 of crus
cerebri,and globus pallidus
 Posterior communicating
artery: runs backward to join
posterior cerebral artery
Vertebral artery
 Cranial branches
 Anterior and posterior spinal
arteries
 Posterior inferior cerebellar
artery
 Branches of basilar artery
 Anterior inferior cerebellar
artery
 Labyrinthine artery
 Pontine arteries
 Superior cerebellar artery
 Posterior cerebral artery
Posterior cerebral artery
 Cortical branches:
supply medial and
inferior surfaces of
temporal lobe and
occipital lobe
 Central branches:
supply dorsal thalamus,
medial and lateral
geniculate bodies,
hypothalamus and
subthalamus
Cerebral arterial circle ( circle of
Willis )
 Formation: formed by
anterior communicating
artery, both anterior
cerebral arteries, internal
carotid arteries, posterior
communicating arteries, and
posterior cerebral arteries
 Position: lies on sella
turcica around optic
chiasma, tuber cinereum
and mamillary bodies
 Area of oxygendeprives brain

Blockage

Thrombus

Plaque
 Microaneurysm

Lenticulostriate arteries

Subarachnoid hemorrhage
Intracerebral
hemorhage

Arteriovenous
malformation
 Veins of brain
Superficial cerebral veins
 Drain blood from cortex

and subcortical
medullary substance and
empty into adjacent
sinuses of dura mater
 Veins of brain
 Deep cerebral veins:
drain deeper parts of
hemispheres, basal
nuclei, internal capsule,
diencephalon and
choroid plexus,
ultimately form great
cerebral vein which
enter straight sinus
Blood vessels of spinal cord
Arteries of spinal cord
 Two sources
 Anterior and posterior spinal
arteries
 Branches of segmental
arteries: radicular arteries
of posterior intercostals
arteries, lumbar arteries,
and lateral sacral arteries
 Damage area:
T1~T4,ventral part of L1
 vascular ring
( vasocorona )
 Blood vessels of spinal cord
Spinal veins: drain into internal vertebral venous plexus