Meninges وهدان

Meninges
 The brain and the spinal cord are surrounded by 3 membranes or coverings called
the meninges.
 From inside outwards, these meninges are; the pia mater, the arachnoid mater
and the dura mater.
A- The Pia Matter
1. It is the intermost covering of the brain. It is closely applied to the surface of the
brain and is carried into all its sulci by the branches of the cerebral arteries.
2. A double fold of pia mater intervenes between the body of the fornix, above,
and the upper surface of the 2 thalami and the roof of the 3rd ventricle,
below. This fold is called the tela choroidea of the 3rd venrticle.
3. Over the lower part of the roof of the fourth ventricle, the pia mater comes in
direct contact with the ependyma forming the tela choroidae of the 4th ventricle.
- It is invaginated into the interior of the ventricle by the choroid plexus. In
this situation, it is pierced by the median aperture of the fourth ventricle.
B- The Arachnoid Mater
1. It is a very thin and delicate membrane which is situated between the pia mater
(inside it) and the dura mater (outside it).
2. The arachnoid mater bridges over the various sulci on the surface of the brain,
i.e. it does not enter the sulci of the brain; but it is carried into the median
longitudinal fissure by the falx cerebri.
3. The subarachnoid space:
 In most sites, the pia and arachnoid are close to each other and are
separated by a narrow space called the subarachnoid space.
 The subarachnoid space contains cerebrospinal fluid, and is crossed by a
reticulum of fine fibres which connect the pia and the arachnoid mater to
each other.

 The blood vessels of the brain lie in the subarachnoid space; the smaller
vessels ramify in the pia mater before entering the substance of the brain.
The subarachnoid space is narrow, but in certain situations, the reticulum of
fine fibres connecting the pia and the arachnoid is much reduced and the two
membranes are widely separated leading to widening of the subarachnoid
space and form the subarachnoid cisterns.
4. The subarachnoid cisterns:
a- The cerebello-medullary cistern: (cisterna magna):
 Lies between the lower part of the cerebellum and the lower part of the
roof of the fourth ventricle.
 The 4th ventricle opens into this cistern by the median aperture of
Magendie through which the CSF drains out from the 4th ventricle to this
cistern.
b- The pontine (ponto-medullary) cistern:
 Lies in front of the pons and medulla oblongata.
 It contains the vertebral and basilar arteries.
 It is traversed by the roots of the lower eight cranial nerves.
 The 4th ventricle opens into this cistern by the 2 lateral apertures of
Luschka through which the CSF drains out from the 4th ventricle to this
cistern.
c- The interpeduncular cistern:
 Lies in the interpeduncular fossa.
 It contains the arteries which form the circulus arteriosus.
 It is traversed by the roots of the third and the fourth cranial nerves.
d- The cistern of lateral fissure:
 Is an extension of the interpeduncular cistern into the main stem of
lateral fissure.
 It contains the middle cerebral artery.
e- The cistern of corpus callosum:
 It extends along the callosal sulcus (on the upper surface of the corpus
callosum).
 It contains the anterior cerebral artery.
f- The chiasmatic cistern:
 Lies around the optic chiasma.
g- Cistern of great cerebral vein :
 Lies just below the splenium of corpus callosum .
 It contains great cerebral vein .
N.B.: All cisterns communicate freely with each other.
5. The arachnoid villi and granulations:
 These are pedunculated projections from the arachnoid mater which push
themselves inside the venous sinuses of the dura; they may even indent the
bone.
 They are found in large numbers especially along the superior sagittal venous
sinus.
 They serve as the channels for drainage of the CSF back to the blood
stream.
C- The Dura Mater
- It is the outermost covering of the brain.

- It is firmly adherent to the inner surface of the skull bones .
- It is forme of two layers (the dura proper and the endoperiosteum) which
cannot be separated from each other except at certain sites where dural
venous sinuses intervene between them.
- Injury of middle meningeal vessels leading to hemorrhage outside the dura
,with separation of dura from the endoperiosteum , is called extradural
hemorrhage .
- At certain sites the dura mater becomes folded to form double-layered
septa between the different parts of the brain e.g. the falx cerebri, the
tentorium cerebelli and the falx cerebelli.
- The subdural space. It is the space which lies between the dura and the
arachnoid mater. It is a capillary space which contains the subdural serous
fluid. In this space subdural hemorrhage may occur due to rupture of one
of cerebral veins .
- At the margin of the foramen magnum, the cranial dura becomes
continuous with the spinal dura. At the margins of other foramina of the
skull, the dura mater becomes continuous with the periosteum on the
outer surface of the skull.
- As the cranial nerves leave the surface of the brain , they carry fine
coverings of pia and arachnoid mater with them and finally they acquire a
further investment from the dura mater which blends with the epineureum .
- The dura form a complete tubular sheath around the optic nerve as far as
the sclera of the eye ball .
Blood Vessels and Nerve Supply of Meninges
Site of Blood supply Nerve supply

dura
A- Anterior and posterior Anterior
Anterior ethmoidal blood vessels ethmoidal nerve
cranial
fossa
B- Middle 1. Middle meningeal 1. Meningeal
cranial artery from branch of
fossa maxillary maxillary
2. Accessory meningeal nerve
artery artery 2. Nervus
spinosus from
mandibular
nerve trunk.
C- Meningeal branches of: 1. Meningeal
Posterior 1. Occipital artery branch of
cranial 2. Vertebral artery vagus
fossa 3. Ascending pharyngeal 2. Meningeal
artery branch of
hypoglossal
nerve
The Cerebrospinal Fluid (CSF)
 It is the fluid which circulates in the ventricles and the central canals of the CNS and
also fills the subarachnoid space and cisterns.
 Production:
 The CSF is secreted by the choroid plexuses in the ventricles of the brain.
 Each ventricle has a choroid plexus: one in the floor of the central part of
each lateral ventricle, one in the medial wall of the inferior horn of each
lateral ventricle, a pair in the roof of the third ventricle and a pair in the roof
of the fourth ventricle.
 How is a choroid plexus formed:
- Each ventricle has a part of its wall extremely thin being formed only of
ependyma which is a single layer of cuboidal epithelium lining the
ventricle.
- At this part the ependyma comes in contact with the pia mater and the 2
layers become invaginated into the interior of the ventricle by a plexus of
capillaries to form the choroid plexus.
- The cuboidal cells of the ependyma extract the fluid from the capillaries
and secrete CSF it into the cavity of the ventricle.
 Circulation of CSF:
 The CSF circulates in the ventricles and the central canals of the CNS.
 After circulation it drain out from the 4th ventricle through the 3
apertures (one median and 2 lateral) found in the roof of the 4th ventricle to
reach the subarachnoid space.
 In the subarachnoid space, the CSF flows over the surface of the brain and
the spinal cord.
 Absorption into the blood stream:
 Later the CSF leaves the subarachnoid space by means of the arachnoid villi
and granulations to drain into the dural venous sinuses.
z
 Functions of CSF:
a- The CSF takes the place of lymph in the CNS which is devoid of lymph
vessels. The CSF is regarded as the principal medium for removal of the waste
products of the nerve cell activity.
b- The CSF in the subarachnoid space acts as a protective water cushion which
protects the brain and the spinal cord and minimize the effects of blows and
shocks.
c- Regulation of the intracranial pressure due to changes in the flow of cerebral
circulation.
 Amount and pressure of CSF:
 The average amount of the CSF in adult is about 135 cc.
 It is constantly absorbed and produced in the rate of 400 to 500 cc daily,
i.e. the CSF is replaced (renewed) three times daily.
 The pressure of the CSF is normally about 100 mm water.
 Any obstruction to the normal passage of the CSF especially at the narrow
foramina and canals causes increased intracranial pressure and dilatation of
the ventricles; a condition known as hydrocephalus.

Meninges وهدان

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Meninges

A- The Pia Matter

B- The Arachnoid Mater

- It is the outermost covering of the brain.

Site of Blood supply Nerve supply

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