Sinuses of the dura mater (venous sinuses, cerebral sinuses): anatomy, functions. Sinuses of the dura mater Superior sagittal sinus

Section of the skull showing the dural sinuses

Sinuses of the dura mater (venous sinuses, sinuses of the brain) - venous collectors located between the layers of the dura mater. They receive blood from the internal and external veins of the brain and participate in the reabsorption of cerebrospinal fluid from the subarachnoid space.

Anatomy

The walls of the sinuses are formed by the dura mater, lined with endothelium. The lumen of the sinuses gapes, valves and muscular tissue, unlike other veins, are absent. In the sinus cavity there are fibrous septa covered with endothelium.

From the sinuses, blood flows into the internal jugular veins; in addition, there is a connection between the sinuses and the veins of the outer surface of the skull through reserve venous outlets.

Venous sinuses

• Superior sagittal sinus(lat. sinus sagittalis superior) - located along the upper edge of the falciform process of the dura mater, ending at the back at the level of the internal occipital protrusion, where it most often opens into the right transverse sinus.
• Inferior sagittal sinus(lat. sinus sagittalis inferior) - spreads along the lower edge of the sickle, flows into the straight sinus.
• Direct sine(lat. sinus rectus) located along the junction of the falciform process with the tentorium cerebellum. It has a tetrahedral shape, goes from the posterior edge of the inferior sagittal sinus to the internal occipital protrusion, opening into the transverse sinus.
• Transverse sinus(lat. sinus transversus) - paired, located in the transverse groove of the skull bones, located along the posterior edge of the tentorium of the cerebellum. At the level of the internal occipital protrusion, the transverse sinuses communicate with each other. In the area of ​​the mastoid angles of the parietal bones, the transverse sinuses pass into sigmoid sinuses, each of which opens through the jugular foramen into the bulb of the jugular vein.
• Occipital sinus(lat. sinus occipitalis) is located in the thickness of the edge of the falx of the cerebellum, extending to the foramen magnum, then splits, and in the form of marginal sinuses opens into the sigmoid sinus or directly into the superior bulb of the jugular vein.
• Cavernous sinus(lat. sinus cavernosus) - paired, located on the sides of the sella turcica. The cavity of the cavernous sinus contains the internal carotid artery with the surrounding sympathetic plexus and the abducens nerve. The oculomotor, trochlear and ophthalmic nerves pass through the walls of the sinus. The cavernous sinuses are connected to each other by intercavernous sinuses. Through the superior and inferior petrosal sinuses they connect, respectively, to the transverse and sigmoid sinuses.
• Intercavernous sinuses(lat. sinus intercavernosi) - located around the sella turcica, forming a closed venous ring with the cavernous sinuses.
• Sphenoparietal sinus(lat. sinus sphenoparietalis) - paired, directed along the small wings of the sphenoid bone, opening into the cavernous sinus.
• Superior petrosal sinus(lat. sinus petrosus superior) - paired, comes from the cavernous sinus along the superior stony groove of the temporal bone and opens into the transverse sinus.
• Inferior petrosal sinus(lat. sinus petrosus inferior) - paired, lies in the lower stony groove of the occipital and temporal bones, connects the cavernous sinus with the sigmoid sinus.

Clinical significance

As a result of injury to the dura mater, which may be caused by a fracture of the skull bones, sinus thrombosis may develop. Sinus thrombosis can also develop as a result

This article is about venous sinuses and blood flow through them. I will try to reproduce the explanation, after which I myself began to understand them a little, being a listener.

Rice. Volumetric reconstruction of the venous sinuses of the dura mater.

The volumetric course of these venous channels is difficult to project onto any one plane. Let's approach the sines from several projections. Let's start from the base of the skull from the cavernous sinuses.

The main tributaries of the cavernous sinus are:

1. veins of the orbit,
2. sphenoparietal sinus,
3. superficial middle veins of the brain.

Outflow of venous blood from the cavernous sinus:

1. superior petrosal sinus,
2. inferior petrosal sinus,
3. pterygoid plexus.

The sinus is paired and is located at the base of the skull on the sides of the sella turcica. The sinus contains many connective tissue septa that divide the sinus cavity into a number of separate interconnected cavities, like the corpus cavernosum.

Rice. View from above. The cavernous sinus is marked with blue dots.

Rice.Side view. The cavernous sinus is marked in blue in the bottom picture. FR - foramen rotundum, CC - foramen lacerum, Se - sella turcica, SOF - superior foramen lacerum, ICA - carotid artery (its cavernous segment).

Rice. Front view. The picture shows a frontal section through the cavernous sinus (blue). The cavernous part of the internal carotid artery, or arteria carotis interna (red) and the surrounding sympathetic fibers pass through the sinus. In addition, cranial nerves (yellow) pass through the walls of the sinus: oculomotor nerve, trochlear nerve, orbital nerve (first branch of the trigeminal nerve), maxillary nerve (second branch of the trigeminal nerve), abducens nerve.

Rice. In the frontal plane, the cavernous sinus projects into the area between the orbits.

Main tributaries of the cavernous sinus.

Rivers through which venous blood fills the lake of the cavernous sinus.

Superior and inferior ophthalmic veins

There are two orbital veins: superior and inferior. Superior ophthalmic vein, v. ophthalmica superior leaves the orbit through superior orbital fissure into the cranial cavity, where it flows into the cavernous sinus. The inferior ophthalmic vein anastomoses with the superior ophthalmic vein and divides into two branches. The superior branch passes through the superior orbital fissure into the cranial cavity and joins the cavernous sinus.

Rice. The orbital veins drain into the cavernous sinus.

The inferior branch leaves the orbit through the inferior orbital fissure and enters the deep vein of the face, v. faciei profunda.

Rice. The superior and inferior ophthalmic veins drain into the cavernous sinus.

The sinus descends along the cranial vault along the coronal suture and passes under the sphenoparietal suture. Next, the sinus passes from the cranial vault to the free edge of the small wings of the sphenoid bone, following them in the medial direction until it flows into the cavernous sinus.

Rice. The sphenoparietal sinuses are shown by arrows.

Superficial middle veins of the brain.

The middle (Sylvian) veins drain into the cavernous and sphenoparietal sinuses. The middle veins provide drainage from the anterior superior parts of the temporal lobes and the posterior parts of the inferior frontal gyri.

Rice. The diagram shows the superficial venous system of the cerebral hemispheres (according to Bailey). The middle cerebral vein, which flows into the cavernous sinus, is marked in blue.
1 - vein of Trolard; 2 - veins of the Rolandic groove; 3 - Labbe vein; 4 - middle cerebral vein; 5 - anastomosis between the branches of the frontal veins and the branches of the middle cerebral vein.

Pterygoid plexus

The venous pterygoid plexus is located between the pterygoid muscles.
The cavernous sinus is connected by a series of anastomoses with the venous pterygoid plexus. The outflow of venous blood from the cranial cavity into the pterygoid plexus occurs through anastomoses passing through the lacerated, oval and Vesalian (if present) foramina of the base of the skull.

Rice. In the center of the picture at the top is the cavernous sinus. Its relationship with the pterygoid plexus is visible.

The middle meningeal veins are such anastomoses that carry venous blood from the cranial cavity to the outside. So, vv. meningeae mediae accompany the artery of the same name, connect along the way with the sphenoid-parietal sinus and, leaving the cranial cavity through the foramen spinosum, flow into the pterygoid (venous) plexus.

Rice. The pterygoid plexus is the venous network in the center of the picture. The plexus is connected to the deep facial vein (Fac) and the maxillary vein (Max), which in turn drain into the internal jugular vein.

In addition to connections with the cranial cavity, blood flows into the pterygoid plexus from the nasal cavity through the sphenopalatine vein, from the temporal fossa through the deep temporal veins, and from the masticatory muscles through the masticatory veins.

Intercavernous sinus

The right and left cavernous sinuses are connected to each other by two transverse anastomoses: the anterior and posterior intercavernous, or intercavernous sinuses, or sinus intercavernosi.

Rice. Anterior and posterior intercavernous, or intercavernous sinuses, orsinus intercavernosi are located between the cavernous sinuses.

Due to this, a closed ring of venous cavities is formed around the sella turcica.

Rice. The photograph of the specimen shows the anterior (SICS) and posterior (IICS) intercavernous sinuses, flanked by the carotid arteries.

The outflow of blood from the cavernous sinuses occurs in the dorsal direction along the superior and inferior petrosal sinuses.

The superior petrosal sinuses originate in the posterior part of the cavernous sinus, pass along the upper edge of the pyramid of the temporal bone and empty into the sigmoid sinus.

Rice. The superior petrosal sinuses are marked with arrows. They start from the cavernous sinus (marked with blue dots), pass along the upper edge of the pyramid of the temporal bone and flow into the sigmoid sinus.

Rice. The inferior stony sinuses run along the slope backwards and downwards (marked by arrows), flow into the internal jugular veins (marked by circles) of the corresponding side.

In the posterior cranial fossa, the foramen magnum is surrounded by a venous ring, similar to the venous rings of the spinal canal. This unpaired plexus, called the main one, connects in front with the cavernous sinuses, and on the sides with the lower stony sinuses. In addition to the connections described, the main plexus also communicates with the venous plexuses of the spinal canal and through the occipital sinus with the transverse sinus.

This concludes the first part about sines.

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The sinuses of the dura mater (sinus durae matris) perform the functions of veins and also participate in the exchange of cerebrospinal fluid. Their structure differs significantly from veins. The inner surface of the sinuses is lined with endothelium, which is located on the connective tissue base of the dura mater. In the area of ​​the grooves on the inner surface of the skull, the dura mater bifurcates and attaches to the bones along the edges of the grooves. In cross section, the sinuses have a triangular shape (Fig. 509). When cut, they do not collapse; there are no valves in their lumen.

Venous blood from the brain, orbit and eyeball, inner ear, skull bones, and meninges enters the venous sinuses. Venous blood from all sinuses predominantly flows into the internal jugular vein, which originates in the region of the jugular foramen of the skull.

The following venous sinuses are distinguished (Fig. 416).
1. The superior sagittal sinus (sinus sagittalis superior) is unpaired, formed on the outer edge of the crescent-shaped outgrowth of the dura mater and the sagittal groove. Sine starts from for. cecum and along the sulcus sagittalis of the cranial vault reaches the internal eminence of the occipital bone. The veins of the cerebral hemispheres and cranial bones flow into the superior sagittal sinus.

2. The inferior sagittal sinus (sinus sagittalis inferior) is single, located on the lower edge of the dura mater falx. It begins in front of the corpus callosum and ends at the junction of the great cerebral vein and the rectal sinus. This place is located in the transverse groove of the brain near the quadrigeminal, where the falx cerebrum and the tentorium of the dura mater of the cerebellum meet.

3. The straight sinus (sinus rectus) is unpaired, located at the junction of the falciform process and the tentorium of the cerebellum. Receives the great cerebral vein and the inferior sagittal sinus. It ends at the confluence of the transverse and superior sagittal sinuses, called the sinus drainage (confluens sinuum).

4. The transverse sinus (sinus transversus) is paired, located in the frontal plane in the groove of the same name in the occipital bone. Extends from the internal eminence of the occipital bone to the sigmoid groove of the temporal bone.

5. The sigmoid sinus (sinus sigmoideus) begins at the posterior lower corner of the parietal bone and ends in the region of the jugular foramen at the base of the skull.

6. The occipital sinus (sinus occipitalis), often paired, is located in the falciform process of the cerebellum, connects the drainage of the sinuses (confluens sinuum), runs parallel to the internal occipital crest, reaching the foramen magnum, where it connects with the sigmoid sinus, internal jugular vein and internal venous plexus of the spinal column .

7. The cavernous sinus (sinus cavernosus) is paired, located on the sides of the sella turcica. The internal carotid artery passes through this sinus, and in its outer wall there are the oculomotor, trochlear, abducens and ophthalmic nerves. The pulsation of the internal carotid artery in the cavernous sinus promotes the ejection of blood from it, since the walls of the sinus are not very flexible.

8. Intercavernosus sinus (sinus intercavernosus) is paired, located in front and behind the sella turcica. Connects the cavernous sinuses and receives the veins of the orbit and blood from the basilar plexus (plexus basilaris), which is located on the slope of the skull and connects the posterior intercavernous sinus, the inferior petrosal sinus and the internal vertebral venous plexus.

9. The superior petrosal sinus (sinus petrosus superior) connects the cavernous and sigmoid sinuses. Located on the superior stony groove of the pyramid of the temporal bone.
10. The inferior stony sinus (sinus petrosus inferior) is paired, establishes an anastomosis between the cavernous sinus and the bulb of the internal jugular vein. This sinus corresponds to the inferior petrosal sulcus and is larger in diameter than the superior petrosal sinus.
11. The sphenoid sinus (sinus clinoideus) is located on the posterior edge of the lesser wings of the sphenoid bone and connects to the sinus cavernosus.
12. Sinus drainage (confluens sinuum) - expansion of the sinuses at the junction of the transverse, superior longitudinal, occipital and direct sinuses. This extension is located on the internal occipital eminence.

The following sinuses of the dura mater of the brain are distinguished.

Dura mater of the brain
brain, dura mater encephali;

1. Superior sagittal sinus, sinus sagittalis superior , located on the convex side of the upper edge of the falx cerebri.

It starts from the cock's crest, goes posteriorly along the midline, gradually increasing in volume, and at the internal occipital protrusion in the region of the cruciate eminence it flows into the transverse sinus.

On the sides of the superior sagittal sinus, between the sheets of the dura mater of the brain, there are numerous slits of varying sizes - lateral lacunae, lacunae laterales, into which granulations are invaginated.

2. Inferior sagittal sinus, sinus sagittalis inferior , lies along the lower edge of the falx cerebri and flows into the straight sinus.

3. Transverse sinus, sinus transversus , is located in the groove of the same name on the occipital bone.

It is the largest of all sinuses. Bending around the mastoid angle of the parietal bone, it continues into the sigmoid sinus, sinus sigmoideus. The latter descends along the groove of the same name to the jugular foramen and passes into the superior bulb of the internal jugular vein.

Two emissary veins open into the sinus, which are connected to the extracranial veins. One of them is located in the mastoid foramen, the other is at the bottom of the condylar fossa of the occipital bone, in the unstable, often asymmetrical, condylar canal.

4. Direct sinus, sinus rectus , located along the line of connection of the falx cerebrum with the tentorium cerebellum. Together with the superior sagittal sinus, they flow into the transverse sinus.

5. Cavernous sinus, sinus cavernosus, got its name due to the numerous partitions that give the sinus the appearance of a cavernous structure.

The sinus is located on the sides of the sella turcica. In cross section, it has the shape of a triangle; there are three walls: upper, outer and inner.

The superior wall is pierced by the oculomotor nerve. Somewhat lower, in the thickness of the outer wall of the sinus, pass the trochlear nerve and the first branch of the trigeminal nerve - the ophthalmic nerve. The abducens nerve lies between the trochlear and ophthalmic nerves.

Inside the sinus passes the internal carotid artery with its sympathetic nerve plexus. The superior ophthalmic vein flows into the sinus cavity.

The right and left cavernous sinuses communicate with each other in the anterior and posterior parts of the sellar diaphragm through the intercavernous sinuses, sinus intercavernosi. The large sinus formed in this way surrounds the pituitary gland lying in the sella turcica on all sides.

6. Sphenoparietal sinus, sinus sphenoparietalis , paired, follows in the medial direction along the posterior edge of the lesser wing of the sphenoid bone and flows into the cavernous sinus.

7. Superior petrosal sinus, sinus petrosus superior , is also a tributary of the cavernous sinus. It is located along the upper edge of the pyramid of the temporal bone and connects the cavernous sinus with the transverse sinus.

8. Inferior petrosal sinus, sinus petrosus inferior, exits the cavernous sinus, lies between the clivus of the occipital bone and the pyramid of the temporal bone in the groove of the inferior petrosal sinus. It drains into the superior bulb of the internal jugular vein. The veins of the labyrinth approach it.

9. Basilar plexus, plexus basilaris, located on the basilar part of the body of the occipital bone. It is formed by the fusion of several connecting venous branches between both inferior petrosal sinuses.

10. Occipital sinus, sinus occipitalis, lies along the internal occipital crest. It emerges from the transverse sinus, divides into two branches, which cover the lateral edges of the foramen magnum and join the sigmoid sinus.

The occipital sinus anastomoses with the internal vertebral venous plexuses. In the place where the transverse, superior sagittal, straight and occipital sinuses connect, a venous expansion is formed, called the sinus drainage, confluence sinuum. This expansion corresponds to the cruciform eminence on the occipital bone.

Veins of the cerebrum, vv. cerebri.

The dura mater of the brain is separated from the underlying arachnoid membrane by the subdural space, spatium subdurale, which are capillary slits that contain a small amount of cerebrospinal fluid.

Superior sagittal sinus

Veins of the brain

Section of the skull showing the dural sinuses

Sinuses of the dura mater (venous sinuses, sinuses of the brain) - venous collectors located between the layers of the dura mater. They receive blood from the internal and external veins of the brain and participate in the reabsorption of cerebrospinal fluid from the subarachnoid space.

Anatomy

The walls of the sinuses are formed by the dura mater, lined with endothelium. The lumen of the sinuses gapes, valves and muscular tissue, unlike other veins, are absent. In the sinus cavity there are fibrous septa covered with endothelium.

From the sinuses, blood flows into the internal jugular veins; in addition, there is a connection between the sinuses and the veins of the outer surface of the skull through reserve venous outlets.

Venous sinuses

• Superior sagittal sinus(lat. sinus sagittalis superior) - is located along the upper edge of the falciform process of the dura mater, ending posteriorly at the level of the internal occipital protrusion, where it most often opens into the right transverse sinus.
• Inferior sagittal sinus(lat. sinus sagittalis inferior) - spreads along the lower edge of the falx, flows into the straight sinus.
• Direct sine(lat. sinus rectus) is located along the junction of the falciform process with the tentorium cerebellum. It has a tetrahedral shape, goes from the posterior edge of the inferior sagittal sinus to the internal occipital protrusion, opening into the transverse sinus.
• Transverse sinus(lat. sinus transversus) - paired, located in the transverse groove of the skull bones, located along the posterior edge of the tentorium of the cerebellum. At the level of the internal occipital protrusion, the transverse sinuses communicate with each other. In the area of ​​the mastoid angles of the parietal bones, the transverse sinuses pass into sigmoid sinuses, each of which opens through the jugular foramen into the jugular bulb.
• Occipital sinus(lat. sinus occipitalis) is located in the thickness of the edge of the falx of the cerebellum, extending to the foramen magnum, then splits, and in the form of marginal sinuses opens into the sigmoid sinus or directly into the superior bulb of the jugular vein.
• Cavernous sinus(lat. sinus cavernosus) - paired, located on the sides of the sella turcica. The cavity of the cavernous sinus contains the internal carotid artery with the surrounding sympathetic plexus and the abducens nerve. The oculomotor, trochlear and ophthalmic nerves pass through the walls of the sinus. The cavernous sinuses are connected to each other by intercavernous sinuses. Through the superior and inferior petrosal sinuses they connect, respectively, to the transverse and sigmoid sinuses.
• Intercavernous sinuses(lat. sinus intercavernosi) - are located around the sella turcica, forming a closed venous ring with the cavernous sinuses.
• Sphenoparietal sinus(lat. sinus sphenoparietalis) - paired, directed along the small wings of the sphenoid bone, opening into the cavernous sinus.
• Superior petrosal sinus(lat. sinus petrosus superior) - paired, comes from the cavernous sinus along the superior petrosal groove of the temporal bone and opens into the transverse sinus.
• Inferior petrosal sinus(lat. sinus petrosus inferior) - paired, lies in the lower stony groove of the occipital and temporal bones, connects the cavernous sinus with the sigmoid sinus.

Clinical significance

As a result of trauma to the dura mater, which may be caused by a fracture of the skull bones, sinus thrombosis may develop. Sinus thrombosis can also develop as a result of a neoplastic or infectious process in the skull. In turn, sinus thrombosis can cause hemorrhagic cerebral infarction.

The sinuses of the dura mater are involved in the formation of dural arteriovenous malformations (DAVM), most often observed in the area of ​​the transverse and sigmoid sinuses, less often in the superior sagittal, petrosal sinuses or the bottom of the anterior cranial fossa (ethmoid DAVM). DAVMs are formed against the background of degenerative changes in the vascular wall, due to trauma or sinus thrombosis. Of the direct DAVMs (or post-traumatic dural arteriovenous fistulas), the most common, due to the anatomical features, is the carotid-cavernous fistula.

Images

Links

• Sapin M.R., Bryksina Z.G. - Human anatomy // Education, 1995
• Svistov D.V. - Pathology of the sinuses and veins of the dura mater

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