CEREBRAL DURA

MATER
Dr. Manuni
• The dura mater is the outermost, thickest and toughest
membrane covering the brain (Dura=hard).

• There are two layers of dura:

I. An outer or endosteal layer which serves as an

internal periosteum or endosteum or endocranium
for the skull bones

II. An inner or meningeal layer which surrounds the

brain. The meningeal layer is continuous with the
spinal dura mater.

• The two layers are fused to each other at all places,

except where the cranial venous sinuses are enclosed
between them.
• The Endosteal Layer or Endocranium

• The endocranium is continuous:

 With the periosteum lining the outside of the skull or
pericranium through the sutures and foramina,
 With the periosteal lining of the orbit through the superior
orbital fissure.

• It provides sheaths for the cranial nerves: the sheaths fuse with
the epineurium outside the skull.
 Over the optic nerve, the dura forms a sheath which becomes
continuous with the sclera.

• Its outer surface is adherent to the inner surface of the cranial

bones by a number of fine fibrous and vascular processes. The
adhesion is most marked at the sutures, on the base of the skull
and around the foramen magnum.
The Meningeal Layer

• At places, the meningeal layer of dura mater is folded on itself to form partitions which divide
the cranial cavity into compartments which lodge different parts of the brain.

• The folds are the :

A. Falx cerebri
B. Tentorium cerebelli
C. Falx cerebelli
D. Diaphragma sellae
Falx Cerebri

• The falx cerebri is a large sickle-shaped fold of dura mater

occupying the median longitudinal fissure between the two
cerebral hemispheres.
• It has two ends:
a. The anterior end is narrow, and is attached to the crista galli.
b. The posterior end is broad, and is attached along the median
plane to the upper surface of the tentorium cerebelli.
• The falx cerebri has two margins:
a. The upper margin is convex and is attached to the lips of the
sagittal sulcus
b. The lower margin is concave and free.
• The falx cerebri has right and left surfaces each of which is
related to the medial surface of the corresponding cerebral
hemisphere.
• Three important venous sinuses are present in relation to this fold.

• The superior sagittal sinus lies along the upper margin; the inferior
sagittal sinus along the lower margin; and the straight sinus along the
line of attachment of the falx to the tentorium cerebelli

Tentorium Cerebelli

• The tentorium cerebelli is a tent-shaped fold of dura mater, forming

the roof of the posterior cranial fossa.

• It separates the cerebellum from the occipital lobes of the cerebrum,

and broadly divides the cranial cavity into supratentorial and
infratentorial compartments.

• The infratentorial compartment, in other words, is the posterior

cranial fossa containing the hindbrain and the lower part of the
midbrain
• The tentorium cerebelli has a free margin and an attached
margin.

• The anterior free margin is U-shaped and free.

• The ends of the 'U' are attached anteriorly to the anterior clinoid
processes.

• This margin bounds the tentorial notch which is occupied by the

midbrain and the anterior part of the superior vermis.
• The outer or attached margin is convex.

• Posterolaterally, it is attached to the lips of the transverse sulci

on the occipital bone, and on the posteroinferior angle of the
parietal bone.

• Anterolaterally, it is attached to the superior border of the

petrous temporal bone and to the posterior clinoid processes.
Along the attached margin there are the transverse and superior
petrosal venous sinuses.
• The trigeminal or Meckel's cave is a recess of dura mater present in relation to the attached
margin of the tentorium.
• It is formed by evagination of the inferior layer of the tentorium over the trigeminal
impression on the petrous temporal bone. It contains the trigeminal ganglion.

• The free and attached margins of the tentorium cerebelli cross each other near the apex of
the petrous temporal bone.

• Anterior to the point of crossing there is a triangular area which forms the posterior part of
the roof of the cavernous sinus, and is pierced by the third and fourth cranial nerves.

• The tentorium cerebelli has two surfaces.

• The superior surface is convex and slopes to either side from the median plane. The falx
cerebri is attached to this surface, in the midline; the straight sinus lies along the line of this
attachment. The superior surface is related to the occipital lobes of the cerebrum.

• The inferior surface is concave and fits the convex superior surface of the cerebellum. The falx
cerebelli is attached to its posterior part.
Falx Cerebelli

• The falx cerebelli is a small sickle-shaped fold of dura mater

projecting forwards into the posterior cerebellar notch.

• The base of the sickle is attached to the posterior part of the

inferior surface of the tentorium cerebelli in the median plane.

• The apex of the sickle is frequently divided into two parts which
are lost on the sides of the foramen magnum.

• The posterior margin is convex and is attached to the internal

occipital crest. It encloses the occipital sinus.

• The anterior margin is concave and free.

Diaphragma Sellae

• The diaphragma sellae is a small circular, horizontal fold of dura mater forming the roof of the
hypophyseal fossa.

• Anteriorly, it is attached to the tuberculum sellae.

• Posteriorly, it is attached to the dorsum sellae.

• On each side, it is continuous with the dura mater of the middle cranial fossa.

• The diaphragma has a central aperture through which the stalk of the hypophysis cerebri
passes.
Blood Supply

• The outer layer is richly vascular.

• The inner meningeal layer is more fibrous and requires little blood supply.

1. The vault or supratentorial space is supplied by the middle meningeal artery.

2. The anterior cranial fossa and the dural lining is supplied by meningeal branches of the
anterior ethmoidal, posterior ethmoidal and ophthalmic arteries.

3. The middle cranial fossa is supplied by the middle meningeal, accessory meningeal, and
internal carotid arteries; and by meningeal branches of the ascending pharyngeal artery.

4. The posterior cranial fossa is supplied by meningeal branches of the vertebral, occipital and
ascending pharyngeal arteries.
Nerve Supply

1. The dura of the vault has only a few sensory nerves which are
derived mostly from the ophthalmic division of the trigeminal
nerve.

2. The dura of the floor has a rich nerve supply and is quite sensitive
to pain,

• The anterior cranial fossa is supplied mostly by the anterior

ethmoidal nerve and partly by the maxillary nerve,

• The middle cranial fossa is supplied by the maxillary nerve in its

anterior half, and by branches of the mandibular nerve and from
the trigeminal ganglion in its posterior half
• The posterior cranial fossa is supplied chiefly by recurrent branches
from first, second and third cervical spinal nerves and partly by
meningeal branches of the ninth and tenth cranial nerves.
VENOUS SINUSES OF DURA MATER

• These are venous spaces, the walls of which are formed by dura mater.

• They have an inner lining of endothelium.

• There is no muscle in their walls.

• They have no valves.

• Venous sinuses receive venous blood from the brain, the meninges, and bones of the skull.

• Cerebrospinal fluid is poured into some of them.

• Cranial venous sinuses communicate with veins outside the skull through emissary veins.

• These communications help to keep the pressure of blood in the sinuses constant.

• There are 23 venous sinuses, of which 8 are paired and 7 are unpaired.
Paired venous sinuses

There is one sinus each on right and left

side.

1. Cavernous sinus.
2. Superior petrosal sinus.
3. Inferior petrosal sinus.
4. Transverse sinus.
5. Sigmoid sinus.
6. Sphenoparietal sinus.
7. Petrosquamous sinus.
8. Middle meningeal sinus/veins,
Unpaired venous sinuses

These are median in position.

1. Superior sagittal sinus.

2. Inferior sagittal sinus.
3. Straight sinus.
4. Occipital sinus.
5. Anterior intercavernous sinus.
6. Posterior intercavernous sinus.
7. Basilar plexus of veins.
 CLINICAL ANATOMY

 Pain sensitive intracranial structures are:

• The large cranial venous sinuses and their tributaries from the surface of the brain
• Dural arteries
• The dural floor of the anterior and posterior cranial fossae
• Arteries at the base of the brain.

 Headache may be caused by

• Dilatation of intracranial arteries
• Dilatation of extracranial arteries
• Traction or distension of intracranial pain sensitive structures
• Infection and inflammation of intracranial and extracranial structures supplied by sensory
cranial nerves and by cervical nerves.
 Extradural and subdural haemorrhages are both common. An extradural haemorrhage can be
differentiated from a subdural haemorrhage because of the following differences.

• The extradural haemorrhage is arterial due to injury to middle meningeal artery; whereas
subdural haemorrhage is venous in nature.

• Symptoms of cerebral compression are late in extradural haemorrhage.

• There is no lucid interval in the case of a subdural haemorrhage. In an extradural

haemorrhage , a lucid interval is present. This is a temporary phase of consciousness between
the earlier unconsciousness of cerebral shock and the later unconsciousness of cerebral
compression.

• In an extradural haemorrhage, paralysis first appears in the face and then spreads to the lower
parts of the body. In a subdural haemorrhage, the progress of paralysis is haphazard.

• In an extradural haemorrhage, there is no blood in the CSF; while it is a common feature of

subdural haemorrhage
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