Dura mater

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Dura mater
Meninges-en.svg
Meninges of the central nervous system
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The dura mater extends into the skull cavity as the dural reflections of the falx cerebri and tentorium cerebelli
Details
Pronunciation UK: /ˈdjʊərəˈmeɪtər/ , US: /-ˈmætər/
Precursor Neural crest
Part of Meninges surrounding the brain and spinal cord
Identifiers
Latin dura mater
MeSH D004388
TA98 A14.1.01.101
A14.1.01.002
TA2 5370
FMA 9592
Anatomical terminology

The dura mater, (or just dura) is the outermost of the three meningeal membranes. The dura mater has two layers, an outer periosteal layer closely adhered to the neurocranium, and an inner meningeal layer known as the dural border cell layer. [1] The two dural layers are for the most part fused together forming a thick fibrous tissue membrane that covers the brain and the vertebrae of the spinal column. [2] But the layers are separated at the dural venous sinuses to allow blood to drain from the brain. [3] The dura covers the arachnoid mater and the pia mater the other two meninges in protecting the central nervous system.

Contents

At major boundaries of brain regions such as the longitudinal fissure between the hemispheres, and the tentorium cerebelli between the posterior brain and the cerebellum the dura separates, folds and invaginates to make the divisions. These folds are known as dural folds, or reflections. [3]

The dura mater is primarily derived from neural crest cells, with postnatal contributions from the paraxial mesoderm. [4]

Structure

The dura mater has several functions and layers. The dura mater is a membrane that envelops the arachnoid mater. It surrounds and supports the dural venous sinuses that reabsorbs cerebrospinal fluid and carries the cerebral venous return, back toward the heart.

Cranial dura mater has two layers which include a superficial periosteal layer that is actually the inner periosteum of the neurocranium (the calvarium and endocranium); and a deep meningeal layer, which is the true dura mater. The dura mater covering the spinal cord is known as the dural sac or thecal sac, and only has one layer (the meningeal layer) unlike cranial dura mater. The potential space between these two layers is known as the epidural space, [5] which can accumulate blood in the case of traumatic laceration to the meningeal arteries.

Folds and reflections

Spinal reflections and folds Gray767.png
Spinal reflections and folds

The dura separates into two layers at dural reflections (also known as dural folds), places where the inner dural layer is reflected as sheet-like protrusions into the cranial cavity. There are two main dural reflections:

Two other dural infoldings are the cerebellar falx and the sellar diaphragm:

Blood supply

This depends upon the area of the cranial cavity: in the anterior cranial fossa the anterior meningeal artery (branch from the ethmoidal artery) is responsible for blood supply, in the middle cranial fossa the middle meningeal artery and some accessory arteries are responsible for blood supply, the middle meningeal artery is a direct branch from the maxillary artery and enter the cranial cavity through the foramen spinosum and then divides into anterior (which runs usually in vertical direction across the pterion) and posterior (which runs posterosuperiorly) branches, while the accessory meningeal arteries (which are branches from the maxillary artery) enter the skull through foramen ovale and supply area between the two foramina, and the in posterior cranial fossa the dura mater has numerous blood supply from different possible arteries:

A. posterior meningeal artery (from the ascending pharyngeal artery through the jugular foramen)
B. meningeal arteries (from the ascending pharyngeal artery through hypoglossal canal)
C. meningeal arteries (from occipital artery through jugular or mastoid foramen)
D. meningeal arteries (from vertebral artery through foramen magnum)

Drainage

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The two layers of dura mater run together throughout most of the skull. Where they separate, the gap between them is called a dural venous sinus. These sinuses drain blood and cerebrospinal fluid (CSF) from the brain and empty into the internal jugular vein.

Arachnoid villi, which are outgrowths of the arachnoid mater (the middle meningeal layer), extend into the dural venous sinuses to drain CSF. These villi act as one-way valves. Meningeal veins, which course through the dura mater, and bridging veins, which drain the underlying neural tissue and puncture the dura mater, empty into these dural sinuses. A rupture of a bridging vein causes a subdural hematoma.

Nerve supply

The supratentorial dura mater membrane is supplied by small meningeal branches of the trigeminal nerve (V1, V2 and V3). [8] The innervation for the infratentorial dura mater are via upper cervical nerves and the meningeal branch of the vagus nerve. [9]

Clinical significance

Many medical conditions involve the dura mater. A subdural hematoma occurs when there is an abnormal collection of blood between the dura and the arachnoid, usually as a result of torn bridging veins secondary to head trauma. An epidural hematoma is a collection of blood between the dura and the inner surface of the skull, and is usually due to arterial bleeding. Intradural procedures, such as removal of a brain tumour or treatment of trigeminal neuralgia via a microvascular decompression, require that an incision is made to the dura mater. To achieve a watertight repair and avoid potential post-operative complications, the dura is typically closed with sutures. If there is a dural deficiency, then a dural substitute may be used to replace this membrane. Small gaps in the dura can be covered with a surgical sealant film.

In 2011, researchers discovered a connective tissue bridge from the rectus capitis posterior major to the cervical dura mater. Various clinical manifestations may be linked to this anatomical relationship such as headaches, trigeminal neuralgia and other symptoms that involved the cervical dura. [10] The rectus capitis posterior minor has a similar attachment. [11]

The dura-muscular, dura-ligamentous connections in the upper cervical spine and occipital areas may provide anatomic and physiologic answers to the cause of the cervicogenic headache. This proposal would further explain manipulation's efficacy in the treatment of cervicogenic headache. [12]

The American Red Cross and some other agencies accepting blood donations consider dura mater transplants, along with receipt of pituitary-derived growth hormone, a risk factor due to concerns about Creutzfeldt–Jakob disease. [13]

Cerebellar tonsillar ectopia, or Chiari malformation, is a condition that was previously thought to be congenital but can be induced by trauma, particularly whiplash trauma. [14] Dural strain may be pulling the cerebellum inferiorly, or skull distortions may be pushing the brain inferiorly.

Dural ectasia is the enlargement of the dura and is common in connective tissue disorders, such as Marfan syndrome and Ehlers–Danlos syndrome. These conditions are sometimes found in conjunction with Arnold–Chiari malformation.

Spontaneous cerebrospinal fluid leak is the fluid and pressure loss of spinal fluid due to holes in the dura mater.

Etymology

The name dura mater derives from the Latin for tough mother (or hard mother), [15] a loan translation of Arabic أم الدماغ الصفيقة (umm al-dimāgh al-ṣafīqah), literally 'thick mother of the brain', matrix of the brain, [16] [17] and is also referred to by the term "pachymeninx" (plural "pachymeninges"). [16]

Additional images

See also

Related Research Articles

Articles related to anatomy include:

<span class="mw-page-title-main">Meninges</span> Three membranes protecting the brain

In anatomy, the meninges are the three membranes that envelop the brain and spinal cord. In mammals, the meninges are the dura mater, the arachnoid mater, and the pia mater. Cerebrospinal fluid is located in the subarachnoid space between the arachnoid mater and the pia mater. The primary function of the meninges is to protect the central nervous system.

<span class="mw-page-title-main">Pia mater</span> Delicate innermost layer of the meninges, the membranes surrounding the brain and spinal cord

Pia mater, often referred to as simply the pia, is the delicate innermost layer of the meninges, the membranes surrounding the brain and spinal cord. Pia mater is medieval Latin meaning "tender mother". The other two meningeal membranes are the dura mater and the arachnoid mater. Both the pia and arachnoid mater are derivatives of the neural crest while the dura is derived from embryonic mesoderm. The pia mater is a thin fibrous tissue that is permeable to water and small solutes. The pia mater allows blood vessels to pass through and nourish the brain. The perivascular space between blood vessels and pia mater is proposed to be part of a pseudolymphatic system for the brain. When the pia mater becomes irritated and inflamed the result is meningitis.

<span class="mw-page-title-main">Internal carotid artery</span> Artery supplying the brain

The internal carotid artery is an artery in the neck which supplies the anterior and middle cerebral circulation.

<span class="mw-page-title-main">Great cerebral vein</span>

The great cerebral vein is one of the large blood vessels in the skull draining the cerebrum of the brain. It is also known as the vein of Galen, named for its discoverer, the Greek physician Galen.

<span class="mw-page-title-main">Subdural hematoma</span> Hematoma usually associated with traumatic brain injury

A subdural hematoma (SDH) is a type of bleeding in which a collection of blood—usually but not always associated with a traumatic brain injury—gathers between the inner layer of the dura mater and the arachnoid mater of the meninges surrounding the brain. It usually results from tears in bridging veins that cross the subdural space.

<span class="mw-page-title-main">Intracranial hemorrhage</span> Hemorrhage, or bleeding, within the skull

Intracranial hemorrhage (ICH), also known as intracranial bleed, is bleeding within the skull. Subtypes are intracerebral bleeds, subarachnoid bleeds, epidural bleeds, and subdural bleeds.

<span class="mw-page-title-main">Epidural space</span> Space between the dura mater and vertebrae

In anatomy, the epidural space is the potential space between the dura mater and vertebrae (spine).

<span class="mw-page-title-main">Epidural hematoma</span> Build-up of blood between the dura mater and skull

Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain and the skull. When this condition occurs in the spinal canal, it is known as a spinal epidural hematoma.

<span class="mw-page-title-main">Falx cerebri</span> Anatomical structure of the brain

The falx cerebri is a large, crescent-shaped fold of dura mater that descends vertically into the longitudinal fissure to separate the cerebral hemispheres. It supports the dural sinuses that provide venous and CSF drainage from the brain. It is attached to the crista galli anteriorly, and blends with the tentorium cerebelli posteriorly.

<span class="mw-page-title-main">Subarachnoid cisterns</span> Spaces around the brain filled with cerebrospinal fluid

The subarachnoid cisterns are spaces formed by openings in the subarachnoid space, an anatomic space in the meninges of the brain. The space is situated between the two meninges, the arachnoid mater and the pia mater. These cisterns are filled with cerebrospinal fluid (CSF).

<span class="mw-page-title-main">Arachnoid mater</span> Web-like middle layer of the three meninges

The arachnoid mater is one of the three meninges, the protective membranes that cover the brain and spinal cord. It is so named because of its resemblance to a spider web. The arachnoid mater is a derivative of the neural crest mesoectoderm in the embryo.

<span class="mw-page-title-main">Dural venous sinuses</span> Venous channels in the dura mater

The dural venous sinuses are venous sinuses (channels) found between the periosteal and meningeal layers of dura mater in the brain. They receive blood from the cerebral veins, and cerebrospinal fluid (CSF) from the subarachnoid space via arachnoid granulations. They mainly empty into the internal jugular vein. 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.

<span class="mw-page-title-main">Straight sinus</span> Venous sinus draining the brain

The straight sinus, also known as tentorial sinus or the sinus rectus, is an area within the skull beneath the brain. It receives blood from the inferior sagittal sinus and the great cerebral vein, and drains into the confluence of sinuses.

<span class="mw-page-title-main">Superior sagittal sinus</span> Anatomical structure of the brain

The superior sagittal sinus, within the human head, is an unpaired dural venous sinus lying along the attached margin of the falx cerebri. It allows blood to drain from the lateral aspects of anterior cerebral hemispheres to the confluence of sinuses. Cerebrospinal fluid drains through arachnoid granulations into the superior sagittal sinus and is returned to venous circulation.

<span class="mw-page-title-main">Falx cerebelli</span> Skull anatomy

The falx cerebelli is a small sickle-shaped fold of dura mater projecting forwards into the posterior cerebellar notch as well as projecting into the vallecula of the cerebellum between the two cerebellar hemispheres.

<span class="mw-page-title-main">Sigmoid sinus</span>

The sigmoid sinuses, also known as the pars sigmoid, are paired dural venous sinuses within the skull that receive blood from posterior transverse sinuses.

<span class="mw-page-title-main">Anterior ethmoidal artery</span>

The anterior ethmoidal artery is a branch of the ophthalmic artery in the orbit. It exits the orbit through the anterior ethmoidal foramen alongside the anterior ethmoidal nerve. It contributes blood supply to the ethmoid sinuses, frontal sinuses, the dura mater, lateral nasal wall, and nasal septum. It issues a meningeal branch, and nasal branches.

<span class="mw-page-title-main">Middle cranial fossa</span>

The middle cranial fossa is formed by the sphenoid bones, and the temporal bones. It lodges the temporal lobes, and the pituitary gland. It is deeper than the anterior cranial fossa, is narrow medially and widens laterally to the sides of the skull. It is separated from the posterior cranial fossa by the clivus and the petrous crest.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

References

  1. ↑ Santorella, E; Balsbaugh, JL; Ge, S; Saboori, P; Baker, D; Pachter, JS (19 October 2023). "Proteomic interrogation of the meninges reveals the molecular identities of structural components and regional distinctions along the CNS axis". Fluids and Barriers of the CNS. 20 (1): 74. doi: 10.1186/s12987-023-00473-w . PMC   10588166 . PMID   37858244.
  2. ↑ Mescher, A (2024). Jonqueira's Basic Histology (17th ed.). McGraw Hill. p. 179. ISBN   9781264930395.
  3. 1 2 Dasgupta, K; Jeong, J (May 2019). "Developmental biology of the meninges". Genesis. 57 (5): e23288. doi:10.1002/dvg.23288. PMC   6520190 . PMID   30801905.
  4. ↑ Gagan, Jeffrey R.; Tholpady, Sunil S.; Ogle, Roy C. (2007). "Cellular dynamics and tissue interactions of the dura mater during head development". Birth Defects Research Part C: Embryo Today: Reviews. 81 (4): 297–304. doi:10.1002/bdrc.20104. PMID   18228258.
  5. ↑ University of New England, The Dura Mater.
  6. ↑ Shepherd S. 2004. "Head Trauma." Emedicine.com.
  7. ↑ Vinas FC and Pilitsis J. 2004. "Penetrating Head Trauma." Emedicine.com.
  8. ↑ 'Gray's Anatomy for Students' 2005, Drake, Vogl and Mitchell, Elsevier
  9. ↑ Keller, Jeffrey T.; Saunders, Mary C.; Beduk, Altay; Jollis, James G. (1985-01-01). "Innervation of the posterior fossa dura of the cat". Brain Research Bulletin. 14 (1): 97–102. doi:10.1016/0361-9230(85)90181-9. ISSN   0361-9230. PMID   3872702. S2CID   4763767.
  10. ↑ Frank Scali; Eric S. Marsili; Matt E. Pontell (2011). "Anatomical Connection Between the Rectus Capitis Posterior Major and the Dura Mater". Spine. 36 (25): E1612–E1614. doi:10.1097/brs.0b013e31821129df. PMID   21278628. S2CID   31560001.
  11. ↑ Hack, GD (Dec 1, 1995). "Anatomic relation between the rectus capitis posterior minor muscle and the dura mater". Spine. 20 (23): 2484–6. doi:10.1097/00007632-199512000-00003. PMID   8610241. S2CID   26183189.
  12. ↑ Gary D. Hack; Peter Ratiu; John P. Kerr; Gwendolyn F. Dunn; Mi Young Toh. "Visualization of the Muscle-Dural Bridge in the Visible Human Female Data Set". The Visible Human Project, National Library of Medicine.
  13. ↑ International Red Cross and Red Crescent Movement - redcross.org Archived 2005-12-14 at the Wayback Machine
  14. ↑ Freeman, MD (2010). "A case-control study of cerebellar tonsillar ectopia (Chiari) and head/neck trauma (whiplash)". Brain Injury. 24 (7–8): 988–94. doi:10.3109/02699052.2010.490512. PMID   20545453. S2CID   9553904.
  15. ↑ Sakka, Laurent (2020), "Anatomy of the Spinal Meninges", Spinal Anatomy, vol. 12, no. 2, Springer International Publishing, pp. 403–419, doi:10.1007/978-3-030-20925-4_26, ISBN   978-3-030-20924-7, PMID   29506096, S2CID   242191187
  16. 1 2 William C. Shiel Jr. "Medical Definition of Dura". Medicine Net. Archived from the original on 2013-12-30. Retrieved 2009-06-01.
  17. ↑ "dura mater (n.)". Etymonline. Douglas Harper.
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