neuroanatomy Neuroanatomy is the study of the structure and organization of the nervous system. In contrast to animals with radial symmetry, whose nervous system consists of a distributed network of cells, animals with bilateral symmetry have segregated, defi ...

, dura mater is a thick membrane made of dense irregular connective tissue that surrounds the

brain A brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as Visual perception, vision. I ...

and

spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the sp ...

. It is the outermost of the three layers of membrane called the

meninges In anatomy, the meninges (, ''singular:'' meninx ( or ), ) 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 ...

that protect the

central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...

. The other two meningeal layers are the

arachnoid mater The arachnoid mater (or simply arachnoid) 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 neura ...

and the pia mater. It envelops the arachnoid mater, which is responsible for keeping in the

cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the ...

. It is derived primarily from the

neural crest Neural crest cells are a temporary group of cells unique to vertebrates that arise from the embryonic ectoderm germ layer, and in turn give rise to a diverse cell lineage—including melanocytes, craniofacial cartilage and bone, smooth muscle, per ...

cell population, with postnatal contributions of the paraxial

mesoderm The mesoderm is the middle layer of the three germ layers that develops during gastrulation in the very early development of the embryo of most animals. The outer layer is the ectoderm, and the inner layer is the endoderm.Langman's Medical Emb ...

Structure

The dura mater has several functions and layers. The dura mater is a membrane that envelops the

. It surrounds and supports the dural sinuses (also called dural venous sinuses, cerebral sinuses, or cranial sinuses) and carries blood from the brain toward the heart. Cranial dura mater has two layers called '' lamellae'', a superficial layer (also called the periosteal layer), which serves as the skull's inner periosteum, called the endocranium and a deep layer called the meningeal layer. When it covers the spinal cord it is known as the ''dural sac'' or thecal sac. Unlike cranial dura mater, spinal dura mater only has one layer, known as the meningeal layer. The potential space between these two layers is known as the epidural space.

Folds and reflections

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: * The

tentorium cerebelli The cerebellar tentorium or tentorium cerebelli ( Latin for "tent of the cerebellum") is an extension of the dura mater that separates the cerebellum from the inferior portion of the occipital lobes. Structure The cerebellar tentorium is an arc ...

exists between and separates the

cerebellum The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebe ...

and

brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is ...

from the occipital lobes of the

cerebrum The cerebrum, telencephalon or endbrain is the largest part of the brain containing the cerebral cortex (of the two cerebral hemispheres), as well as several subcortical structures, including the hippocampus, basal ganglia, and olfactory bulb. ...

. * The falx cerebri, which separates the two hemispheres of the brain, is located in the longitudinal cerebral fissure between the hemispheres. Two other dural infoldings are the cerebellar falx and the sellar diaphragm: * The cerebellar falx (falx cerebelli) is a vertical dural infolding that lies inferior to the cerebellar tentorium in the posterior part of the posterior cranial fossa. It partially separates the cerebellar hemispheres. * The sellar diaphragm is the smallest dural infolding and is a circular sheet of dura that is suspended between the clinoid processes, forming a partial roof over the hypophysial fossa. The sellar diaphgram covers the pituitary gland in this fossa and has an aperture for passage of the infundibulum (pituitary stalk) and hypophysial veins.

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 posteriosuperiorly) 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

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 The dural venous sinuses (also called dural sinuses, cerebral sinuses, or cranial sinuses) are venous channels found between the endosteal and meningeal layers of dura mater in the brain. They receive blood from the cerebral veins, receive cere ...

. These sinuses drain blood and

(CSF) from the brain and empty into the

internal jugular vein The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve. It begins in the poste ...

. Arachnoid villi, which are outgrowths of the

(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 In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and che ...

(V1, V2 and V3). The innervation for the infratentorial dura mater are via upper cervical nerves and the meningeal branch of the vagus nerve.

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 A brain tumor occurs when abnormal cells form within the brain. There are two main types of tumors: malignant tumors and benign (non-cancerous) tumors. These can be further classified as primary tumors, which start within the brain, and second ...

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 Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a resu ...

, trigeminal neuralgia and other symptoms that involved the cervical dura. The

rectus capitis posterior minor The rectus capitis posterior minor (or rectus capitis posticus minor, both being Latin for ''lesser posterior straight muscle of the head'') arises by a narrow pointed tendon from the tubercle on the posterior arch of the atlas, and, widening as i ...

has a similar attachment. 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. 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. Cerebellar tonsillar ectopia, or

Chiari Chiari may refer to: * Chiari (surname) *Chiari, Lombardy, a commune in Italy * The Chiari Institute, a medical institution in Great Neck, New York *Battle of Chiari (1701), part of the War of the Spanish Succession See also * Arnold–Chiari malf ...

, is a condition that was previously thought to be congenital but can be induced by trauma, particularly whiplash trauma. 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 Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with long arms, legs, fingers, and toes. They also typically have exceptionally flexible joints a ...

and Ehlers–Danlos syndrome. These conditions are sometimes found in conjunction with

Arnold–Chiari malformation Chiari malformation (CM) is a structural defect in the cerebellum, characterized by a downward displacement of one or both cerebellar tonsils through the foramen magnum (the opening at the base of the skull). CMs can cause headaches, difficulty ...

. 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)'', a loan translation of Arabic (), literally 'thick mother of the brain', matrix of the brain, and is also referred to by the term "pachymeninx" (plural "pachymeninges").

Additional images

File:Blausen 0327 Dura.png, Dura mater (spinal section) File:Gray769.png, Diagrammatic representation of a section across the top of the skull, showing the membranes of the brain, etc. File:Gray770-en.svg, Diagrammatic transverse section of the medulla spinalis and its membranes. File:Slide1drdr.GIF, Spinal cord. Spinal membranes and nerve roots.Deep dissection. Posterior view. File:Slide3dsdd.GIF, Spinal cord. Spinal membranes and nerve roots.Deep dissection. Posterior view File:Streptococcus_pneumoniae_meningitis,_gross_pathology_33_lores.jpg, Autopsy. Dura mater is retracted by the forceps.

References

External links

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youtube: exposure of falx cerebri, dura mater & arachnoid
{{Authority control Meninges