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You are watching: Describe the extensions of the dura mater

StatPearls . Sweetheart Island (FL): StatPearls Publishing; 2021 Jan-.


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Introduction

The dura mater frequently gets referred to as merely the dura. It is one of the class of connective organization that comprise the meninges of the mind (pia, arachnoid, and dura, from inside to outside). The is the outermost layer of the three meninges that surround and protect the brain and spinal cord. The dura mater is consisted of of fibroblasts and big amounts of extracellular collagen.<1>

The dura mater is written of two layers: the periosteal/endosteal layer and the meningeal layer. The dural venous sinuses are between these two layers. The dura crease to kind septa that produce the falx cerebri, tentorium cerebelli, falx cerebelli, and diaphragma sellae.


Structure and also Function

The periosteal or endosteal layer of the dura mater is simply a great of periosteum that covers the inner surface ar of the skull. The class does not extend past the foramen magnum to become contiguous through the dura mater that the spinal cord. The spinal cord dura mater has actually no periosteal layer.

In the brain, the periosteal layer provides a tubular sheath-like extending for the cranial nerves as they pass through the various foramina that the skull. As quickly as the cranial nerves departure the foramen, the periosteal class fuses v the epineurium that nerves.

The meningeal class of the dura mater is a durable, dense fibrous membrane that passes through the foramen magnum and also is continuous with the dura mater the the spinal cord. The meningeal layer of the dura mater creates numerous dural crease that division the cranial cavity into freely connecting spaces. The duty of the dural wrinkle is to limit the rotational displacement of the brain.

The crease include the following:


Falx cerebelli is a upright fold that separates the 2 cerebellar hemispheres and also lies inferior to the tentorium cerebelli.
Tentorium cerebelli is a crescent-shaped wrinkles of the dura mater and forms a roof end the posterior cranial fossa. The shields the exceptional surface that the cerebellum and supports the occipital lobes the the cerebral hemispheres.
Diaphragma sellae is a small circular wrinkles of dura that forms the roof that the sella turcica. The diaphragma sellae has actually a tiny opening in the center segment that allows the i of the stalk the the pituitary gland.

Potential Spaces

The dura mater offer the following function:<5>


Envelops and protect the mind and spinal cord
Regulate the generation and also migration the neural progenitors
Limit the rotational displacement that the brain

Embryology

The dural mater originates indigenous the somitic mesoderm, i beg your pardon condenses roughly the neural tube shortly after the neural tube closes in ~ the embryonic day 9, when the pia and arachnoid (leptomeninges) originate from the neural crest.<5><6>

The dura, forms between the arachnoid mater and the calvarial mesenchyme, which eventually forms the calvarial bones.<7>

The very first of the dural procedures to build is the tentorium cerebelli.<6>

Research has displayed that fetal meninges play critical role during brain development. The dura mater impacts the proliferation and also migration of neural progenitors cells and also neurons in the prosencephalon (forebrain) and also rhombencephalon (hindbrain).<7>


Blood Supply and Lymphatics

The dura mater obtain vascular supply from the complying with branches:


Internal carotid artery

Surgical Considerations

The dura mater is really important come the clinician due to the fact that it is a obstacle to the internal atmosphere of the brain, and also surgically, the neurosurgeon and clinician who interpret imaging should understand its anatomy.<9>

Dural tears room a frequent complication the lumbar spine surgery.<10>

Lumbar Puncture

Diagnostic lumbar puncture is one of the most typically performed invasive exam in clinical medicine.<11> Some typical indications for lumbar puncture encompass evaluation of inflammatory or infectious condition of the nervous mechanism (viral, bacterial, tuberculous, or fungal meningitis) and acute headache.

Knowledge of the anatomy that the lumbar spine is important for everyone performing a lumbar puncture. The lumbar puncture needle transverses the following structures in order: skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater, and lastly the subarachnoid an are where cerebrospinal liquid (CSF) is stored.<11>


Clinical Significance

After head trauma, a patient may develop an epidural (extradural) or subdural hematoma. The hematoma can lead to a fast rise in intracranial pressure, and also death can an outcome if not treated.

Epidural Hematoma

In one epidural hematoma, the arterial blood collects between the endosteal layer of the dura and the skull. The vessel frequently connected is the middle meningeal artery (MMA), which may be ruptured or torn together a result of dull or penetrating mind trauma.<12><3> The middle meningeal artery is a tributary of the maxillary artery, and the maxillary artery is just one of the terminal branches the the outside carotid artery.

Subdural Hematoma

In a subdural hematoma, over there is a arsenal of venous blood between the dura and the arachnoid mater. The hematoma frequently is because of injury or rupture of the subdural veins as they empty into the dural venous sinuses. Subdural hematoma occurs from the rupture of bridging veins, typically from head trauma. Due to the fact that the venous pressure in the veins is low, the hematoma is not commonly large, and progression is not rapid. An increase in intracranial pressure deserve to increase the price of bleeding from the ruptured bridging veins.<13> The anatomy the the bridging vein provides it vulnerable to tearing in ~ the border cabinet layer of the dura mater.<13>

Subdural bleeding (SDB) in infants is considered an essential symptom that nonaccidental head injury.

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The Sensitivity that the Dural Mater

The dura mater is very sensitive to stretch. Any type of irritation the the dura often reasons a sensation of a headache, e.g., meningitis, hematoma.