The Meninges and Blood Vessels of

Brain and Spinal Cord,

and the Cerebrospinal Fluid
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
arteryJoined 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 branche
– Anterior and posterior spinal
arteries
– Posterior inferior cerebellar
artery

• Branches of basilar
artery
– Anterior inferior cerebral 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