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Meninges of the brain and spinal cord

Dura mater

Arachnoid mater

Pia mater Author: Jana Vasković MD • Reviewer: Roberto Grujičić MD

Last reviewed: June 14, 2022
Spinal meninges Reading time: 18 minutes

Meningeal spaces '

Epidural space
The meninges are the three membranes that
Subdural space /
envelop the brain and spinal cord and separate
Subarachnoid space them from the walls of their bony cases (skull
Clinical relations and vertebral column). Based on their location,
Sources meninges are referred to as the cranial
meninges which envelop the brain, and spinal
50:58 of trial remaining meninges which envelop the spinal cord.
However, the cranial and spinal meninges are
continuous with each other and consist of the
same three meningeal layers. From superficial
to deep the meninges are the: Meninges of the brain

Dura mater, also known as the pachymeninx

Arachnoid mater
Pia mater

These layers bound three clinically important potential spaces: the epidural,
subdural, and subarachnoid spaces. The function of the meninges is to protect the
brain and spinal cord from mechanical trauma, to support the blood vessels and to
form a continuous cavity through which the cerebrospinal fluid (CSF) passes.
Specifically, the CSF passes between the inner two meningeal layers (arachnoid and
pia) which are together called the leptomeninges.

This article will discuss the anatomy and function of the cranial and spinal
meninges.

Key facts about the meninges Table quiz

Definition Three membranous layers that envelop the brain and the spinal cord

Meninges and Meninges: Dura mater, arachnoid mater, pia mater

meningeal spaces Meningeal spaces: Epidural space, subdural space, subarachnoid space

Function Mechanical protection of brain and spinal cord, support of cerebral and spinal
blood vessels, passage of the cerebrospinal fluid (CSF)

Contents

1. Dura mater
2. Arachnoid mater
2.1. Arachnoid granulations
+ Show all
2.2. Subarachnoid cisterns

11:40

Recommended video: Meninges of the brain

Meninges and superficial vessels of the brain.

Dura mater .

The cranial dura mater is the outermost

/
meningeal layer, consisting of dense irregular
connective tissue. It is composed of two layers;

The superficial layer is the periosteal cranial

dura. It overlies the inner table of the cranial + ,
vault bones, acting like the periosteal layer of
the cranium.
The meningeal cranial dura, which lies
superficial to the arachnoid mater.

The two dural layers are firmly attached to each

Dura mater​ ( 1/6 )
other, except in places where they separate to
enclose the dural venous sinuses. In these
Synonyms: Pachymeninx
places, the meningeal layer projects inward,
towards the cerebral tissue, forming the fibrous
septa that partially separate the cranial cavity. The fibrous septa within the cranium
are the:

Falx cerebri, which is the largest of fibrous septa. It extends across the midline on
the inner surface of the calvaria, from crista galli to the internal occipital
protuberance. It separates the left and right cerebral hemispheres and houses the
superior sagittal and inferior sagittal sinuses. Posteriorly, the falx blends with
tentorium cerebelli.
Tentorium cerebelli, which spans in a transverse plane from the inner surface of
the occipital bone. It separates the cerebrum from the cerebellum and contains
the transverse, straight and superior petrosal sinuses. The tentorium divides the
intracranial space into supratentorial and infratentorial compartments that
contain the forebrain and hindbrain, respectively.
Falx cerebelli, which projects from the midline of the occipital bone. It separates
the hemispheres of the cerebellum and houses the occipital sinus.
Diaphragma sellae, which is a flat membrane that surrounds the pituitary stalk
and forms a roof over the hypophyseal fossa. It contains the anterior and
posterior intercavernous sinuses.

The meningeal dura mater overlies the trigeminal ganglion, enclosing it in a

compartment known as the trigeminal cave (Meckel’s cave).

Struggling to understand the dural septa? Learn the parts of the brain with
our diagrams and quizzes!

Arachnoid mater .

The cranial arachnoid mater is a spiderweb-like

/
meningeal layer, interposed between the dura
and pia. The potential space between the
arachnoid and dura is called the subdural space
and according to some authors, it contains a
very thin layer of fluid. The space between the + ,
arachnoid and pia is called the subarachnoid
space and it is filled with the cerebrospinal fluid
(CSF). Additionally, all cerebral arteries and veins
are located in this space.

The outer surface of the arachnoid attaches to Arachnoid mater​ (

Arachnoidea mater​ (
1/6 )
the dura mater forming a barrier that prevents
the leakage of CSF into the subdural space. At
the sites where dura forms the venous sinuses, the arachnoid shows mushroom-
like protrusions called the arachnoid granulations. The inner surface of arachnoid
shows thin fibrous projections called the arachnoid trabeculae that traverse the
subarachnoid space and attach to the outer surface of the pia mater. Due to their
embryological and cellular similarities the pia mater and arachnoid together are
referred to as the leptomeninges.

Arachnoid granulations

05:25

Recommended video: Arachnoid mater

Definition, location and structure of the arachnoid mater.

The arachnoid granulations (Pacchionian bodies) are protrusions of the arachnoid

mater that pierce the meningeal dura and protrude into the lumina of the dural
venous sinuses. The core of each arachnoid granulation is continuous with the
subarachnoid space, therefore, containing the cerebrospinal fluid.

The CSF diffuses through the lining of the arachnoid granulations into the dural
venous sinuses. Therefore, the function of the arachnoid granulations is to enable
the continuous drainage of the cerebrospinal fluid from the subarachnoid into the
vascular system. It is important that the CSF drainage is held in balance with the
production of new CSF from the choroid plexus, warranting a constant amount of
the CSF in the brain (normally around 150 milliliters). Since the skull is a rigid case,
any increase in the amount of CSF in the brain increases the intracranial pressure
and can cause various neurological disorders (e.g. hydrocephalus)

Subarachnoid cisterns

The arachnoid mater does not follow precisely

/
the contours of the brain. Moreover, in certain
sites, it completely separates from the pia
mater, thus forming the expansions of the
subarachnoid space, called the subarachnoid
cisterns. There are 10 major subarachnoid + ,
cisterns of the brain that are continuous with
each other through the general subarachnoid
space. These include the:

1. Cisterna magna (cerebellomedullary cistern)

2. Pontine cistern Posterior
cerebellomedullary
3. Chiasmatic cistern cistern​ (
Cisterna
1/5 )
4. Quadrigeminal cistern cerebellomedullaris
posterior​ (
5. Interpeduncular cistern
Synonyms: Cisterna magna
6. Ambient cistern
7. Crural and carotid cisterns
8. Cistern of lateral cerebral fossa (Sylvian cistern)
9. Cerebellopontine cistern
10. Cistern of lamina terminalis

Learn more about the subarachnoid cisterns with our video tutorials, quizzes,
articles, and labelled diagrams.

Cerebrospinal fluid production * Custom quiz: Subarachnoid

and circulation cisterns of the brain
Explore study unit Start quiz

Pia mater .

The cranial pia mater is a highly vascular

/
membrane that closely follows the contours of
the brain. It doesn’t lie on the surface of the
brain directly but rather is separated from it by
a thin space called the subpial space formed by
the end-feet of the astrocytes (glia limitans). + ,
Many superficial blood vessels of the brain are
related to the pia mater. However, given that it
is a very thin membrane, these blood vessels are
partially embedded within the thickness of the
pia, while partially are suspended by the
arachnoid trabeculae. Pia mater​ ( 1/2 )

The function of the pia mater is to physically

separate the neural tissue from the blood vessels in the subarachnoid space, adding
to the efficacy of the blood-brain barrier. Furthermore, it contributes to the
degradation of the neurotransmitters, preventing their prolonged action on the
nervous tissue.

Take the quiz below to test your knowledge on the meninges and superficial vessels
of the brain!

Meninges and superficial vessels of the brain.

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(26 structures).

96 26 24
Basic structure Advanced structure Exam questions
identification questions identification questions (Question bank)

Spinal meninges .

Spinal dura mater

The dura mater of the spinal cord differs from

/
that of the brain by having only one layer; the
meningeal layer. The periosteal layer is missing
because the vertebral canal, unlike the skull, has
its own, true periosteum. The spinal dura mater
attaches to the tectorial membrane and + ,
posterior longitudinal ligament superiorly.
Inferiorly, it extends up to S2 vertebral level,
thus extending below the spinal cord
termination (L1/L2).

The space between the spinal dura mater and Dura mater of spinal
cord​ ( 1/5 )
the periosteum of the vertebral column is called Dura mater spinalis​ (
the epidural space. It is filled with loose
connective and adipose tissues, and traversed by
the anterior and posterior internal vertebral venous plexuses.

Spinal arachnoid mater

The arachnoid mater of the spinal cord is

/
continuous with that of the brain. It lies close
and beneath the spinal dura, with a narrow
subdural space existing between them. Deep to
the arachnoid is the spinal pia mater. Between
arachnoid and pia, there is the spinal + ,
subarachnoid space. This space expands at the
level of the conus medullaris of the spinal cord,
forming the lumbar cistern.

The lumbar cistern extends from L1-S2 and it

contains the dorsal and ventral rootlets of L2- Arachnoid mater of
spinal cord​ (
Co spinal nerves (cauda equina). It is clinically Arachnoidea mater
1/4 )
significant as it is the site of lumbar puncture spinalis​ (

(extraction of CSF for biochemical,

microbiological and cytological analyses or application of certain medicine).

Spinal pia mater

The spinal pia mater continues onto the cranial

/
pia at the level of the foramen magnum. It
closely envelops the spinal cord, containing a
vascular plexus for the spinal cord tissue. From
the apex of the conus medullaris, the pia mater
gives off a fibrous projection called the filum + ,
terminale. The filum terminale extends around
20 centimeters downwards and attaches to the
periosteum of the first coccygeal vertebra.

Starting from the level of the foramen magnum

to the level of vertebra T12, the spinal pia shows Pia mater of spinal
cord​ ( 1/3 )
21 pairs of ligamentous lateral projections that Pia mater spinalis​ (
pass through the arachnoid and attach to the
spinal dura mater. These projections are called
the denticulate ligaments. Each pair of denticulate ligaments is located halfway
between the successive pairs of the spinal nerves. The function of denticulate
ligaments is to position and hold the spinal cord in place.

Consolidate your knowledge of the spinal meninges and meningeal spaces with the
following quiz.

* Custom quiz: Spinal

meninges and meningeal spaces
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Meningeal spaces .

The meningeal spaces are the spaces between the meningeal layers. There are three
clinically significant meningeal spaces; epidural, subdural, and subarachnoid. We
have described the anatomy of each of the spaces in the text above, however, we’d
like to recap the most important facts and sum them up in the following
paragraphs.

Epidural space

“Epi” is a prefix indicating that something is

/
“above”. Thus, it should come easy to remember
that the cranial epidural space is a potential
space between the superficial layer of dura
mater and the calvarium. On the other hand, the
spinal epidural space is located between the + ,
spinal dura mater and the tissues that line the
vertebral canal.

The spinal epidural space is a site of applying the

local epidural anesthesia. The procedure may be
performed at any vertebral level, and the choice Epidural space​ (
Spatium epidurale​ (
1/1 )
depends on the body region that is desired to
be anesthetized for an upcoming Synonyms: Peridural space, Spatium
surgical/obstetric procedure. The applied epidurale spinale, show more...

anesthetics (e.g. lidocaine) anesthetize the local

spinal nerve rootlets resulting in analgesia (pain
relief).

Subdural space

“Sub” is a prefix that tells us that something is “below”. So, the subdural space is a
potential space between the dura mater and the underlying arachnoid mater. The
spinal subdural space is continuous with the cranial subdural space. They’re both
very narrow and likely contain a thin film of fluid.

Subarachnoid space

The subarachnoid space is a space between the

/
arachnoid and pia mater. The subarachnoid
space contains cerebrospinal fluid (CSF) and
major blood vessels and provides expansions
known as cisterns. The subarachnoid spaces of
the cranium and vertebral column are + ,
continuous with each other, creating a closed
route for the CSF circulation. Let’s recap the
route of the cerebrospinal fluid in order to
understand the continuity of the subarachnoid
space;
Subarachnoid space​ (
Spatium 1/1 )
The CSF is formed by the cells of the choroid subarachnoideum​ (
plexus within the walls of the brain ventricles.
Synonyms: Leptomeningeal space,
The fluid passes from the lateral to the third Spatium leptomeningeum, show
ventricle, and then to the fourth ventricle. more...

From the fourth ventricle, the CSF passes into

the central canal of the spinal cord and into the interpeduncular and
quadrigeminal subarachnoid cisterns.
The CSF then reaches the subarachnoid space of the brain and spinal cord,
circulating through them.
Finally, the CSF is reabsorbed into the dural venous sinuses by diffusing through
the subarachnoid granulations in the cranial subarachnoid space.

Clinical relations .

Epidural bleeding

Epidural hemorrhage is a rare condition caused by the rupture of one of the

meningeal vessels. Usually, the source of bleeding is the middle meningeal
artery, or rarely, one of the dural venous sinuses. Epidural bleeding usually
occurs due to a fracture of the parieto-temporal region of the skull which
often causes a rupture of the aforementioned blood vessels. The
hemorrhage separates the periosteal dura mater from the skull, forming the
epidural hematoma between the calvaria and dura mater.

The epidural bleeding usually affects the younger population, since with age,
the periosteal dura gets more firmly attached to the diploë. The epidural
hematoma is diagnosed with CT, on which it is seen as a biconvex
hyperdense formation. The biconvex form is usually caused by a firm
attachment of the dura to the cranial sutures, limiting the bleeding. If
treated surgically and on time, the individual usually recovers fully within a
couple of days.

Subdural bleeding

Subdural hemorrhage refers to the process of collecting the blood within

the subdural space, between the dura and arachnoid mater. It is usually
caused by a traumatic injury to the head and rupture of the bridging veins
that connect the superficial veins of the brain with the dural venous sinuses.
The subdural hematoma is usually located in the convexities of the skull.
They are usually diagnosed by head CT, in which they are seen as high-
density crescent shaped formations. Subdural hematoma are divided into
acute and chronic, depending on the timeframe of their formation.

Acute subdural hematoma is mostly caused by a strong force that rips the
bridging veins, has progressive growth and is often associated with
underlying brain injury. If it’s compressing the brain it is surgically treated
by evacuation. Small asymptomatic cases, however, may be managed
expectantly.
Chronic subdural hematoma can result from even an insignificant or weak
trauma of the head. It usually occurs in the elderly. Other risk factors are
alcohol abuse, seizures, CSF shunts, coagulopathies and patients at risk for
falls (e.g. hemiparesis from a stroke). The patients frequently don’t even
remember any trauma that might have caused the subdural bleeding, as it
usually happens during falls which they don’t perceive as significant.The
chronic subdural bleeding and the formation of the hematoma is quite
slow. The symptoms appear only once the hematoma reaches a critical
size so it starts pressing the underlying brain tissue. The chronic subdural
bleeding is diagnosed usually with a CT, on which it is seen as a crescent-
shaped formation with a fibrous capsule. The treatment is the same as for
the acute subdural hematoma, i.e. neurosurgical procedure.

Subarachnoid bleeding

Subarachnoid hemorrhage (SAH) is the most common post-traumatic

bleeding. Note that it can also be non-traumatic, related to the rupture of
an intracranial aneurysm or arterial malformation.

The key symptom of this condition is a sudden onset of a headache which

patients describe as the worst they’ve ever had in their life. Other symptoms
include deterioration of consciousness (confusion, stupor or even coma) and
positive meningeal signs. It is diagnosed with Angio-CT, classical angiography,
or lumbar puncture. The treatment is oriented towards three key principles;

Support of vital functions - breathing and heart rate.

Treating the cause of bleeding - neurosurgical closing of the ruptured
blood vessel.
Avoiding vasospasm due to the degradation of the blood and reflexive
vasoconstriction.

Sources .

All content published on Kenhub is reviewed by medical and anatomy experts. The
information we provide is grounded on academic literature and peer-reviewed research.
Kenhub does not provide medical advice. You can learn more about our content creation
and review standards by reading our content quality guidelines.

References:

Augustine, G. J., Fitzpatrick, D. (2004). Neuroscience (3rd ed.). Sunderland, MA, USA:
Sinauer Associates.
Blumenfeld, H. (2018). Neuroanatomy through clinical cases (2nd ed.). Sunderland, MA:
Sinauer.
Haines, D. E., Mihailoff, G. A. (2018). Fundamental neuroscience for basic and clinical
applications. Philadelphia, PA: Elsevier.
Haines, D.E. (2014). Neuroanatomy in clinical context: An atlas of structures, sections,
systems and syndromes (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Mancall, E. L., Brock, D. G., & Gray, H. (2011). Gray’s clinical neuroanatomy: the anatomic
basis for clinical neuroscience. Philadelphia, PA: Elsevier.
Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Clinically Oriented Anatomy (7th ed.).
Philadelphia, PA: Lippincott Williams & Wilkins.
Netter, F. (2019). Atlas of Human Anatomy (7th ed.). Philadelphia, PA: Saunders.
Patestas, M. A., Gartner, L. P., & Patestas, M. A. (2009). A Textbook of Neuroanatomy.
Oxford, UK: Blackwell Publishing.
Snell, Richard S. (2018) Clinical neuroanatomy (8th ed.). Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins
Standring, S. (2016). Gray's Anatomy (41tst ed.). Edinburgh: Elsevier Churchill Livingstone

Illustrators:

Meninges - Paul Kim

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