Meninges brain and spine Flashcards
Name the two layers of the dural matter
Periosteal layer
Meningeal layer
- Vascularisation of the dura matter?
2. Innervation of the dura matter?
- Middle meningeal artery and vein
2. Trigeminal nerve V1, V2, V3
Does the dura have BBB?
No the dura lacks BBB
Name the dural reflections
Falx cerebri
Tentorium cerebelli
Falx cerebelli
Diaphragma sella
What is the tentorial notch?
Opening in the anterior part of the tentorium cerebelli for the passage of the midbrain . Also called tentorial notch
What are the dural venous sinuses?
Venous channels located between the two layers of the dura matter
Innervation and vascularisation of the arachnoid and pia matter?
Arachnoid: Avascular, no innervation
Pia matter: Highly vascularised
Layers of pia matter
Epipial layer
Intima pia
What is a perivascular space ?
Space between the vessel wall and the pia
Name the layers of the spinal meninges?
Dura, Arachnoid, Pia matter
Which layer of the cranial dura mater continues in the spine?
The meningeal layer
The endosteal layer stops at the foramen Magnum
Describe the spinal spaces
The Epidural Space (true space) between dura and periosteum (contains Fat, Internal venous plexus, spinal roots below S2)
The subdural space (virtual space) between arachnoid and pia (contains arachnoid trabeculae, CSF, Vessels)
Where are usually (if ever) subdural haematomas in the spine?
Ventrally (while epidural ventral or dorsally)
What is the origin of the arachnoid and pia matter?
Dura matter?
Arachnoid + Pia = Ectoderm
Dura: Mesoderm
What is the origin of all meninges?
Perimedullary mesenchyme
Describe the patterns of dural enhancement
a. Pachymeningeal = Dura and arachnoid
b. Pia-subarachnoid = Leptomeningeal enhancement
Pachymeningeal enhancement differential
Intracranial hypotension Post-operative changes Granulomatous disease Meningioma Metastasis Lymphoma
Pia-Subarachnoid enhancement differential
Meningitis (bacterial, viral, fungal)
Carcinomatous meningitis
Thick lumpy nodular enhancement
Bilateral thin - linear enhancement suggests
Carcinomatosous meningitis
Infectious meningits
Unilateral thin - linear enhancement suggests
IgG pachymeningitis
Sturge-Weber
Neurosarcoidosis
Vasculitis
What is the best sequence for meningitis?
New sequece?
CE FLAIR
CE 3D T1 TSE black blood
Imaging findings of meningitis?
High FLAIR CSF spaces Dural/meningeal enhancement Hydrocephalus Subdural effusions/empyema Infarcts Restricted diffusion VR spaces
Findings of neurosarcoid?
Solitary or multifocal masses Dural (30-50%) meningeal (30%) Optic chiasm, hypothalamus, infudibulum Cranial nerves Spine
