Anatomy and development of the meninges: implications for subdural collections and CSF circulation.
The dura is traditionally viewed as a supportive fibrous covering of the brain containing the dural venous sinuses but otherwise devoid of vessels and lacking any specific function. However, review of the embryology and anatomy reveals the dura to be a complex, vascularized and innervated structure, not a simple fibrous covering. The dura contains an inner vascular plexus that is larger in the infant than in the adult, and this plexus likely plays a role in CSF absorption. This role could be particularly important in the infant whose arachnoid granulations are not completely developed. Although subdural hemorrhage is frequently traumatic, there are nontraumatic conditions associated with subdural hemorrhage, and the inner dural plexus is a likely source of bleeding in these nontraumatic circumstances. This review outlines the development and age-specific vascularity of the dura and offers an alternative perspective on the role of the dura in homeostasis of the central nervous system.
Mack
Julie
J
Department of Radiology, Penn State Hershey Medical Center, 30 Hope Drive, Suite 1800, P.O. Box 859, Hershey, PA, 17033-0859, USA. jmack@hmc.psu.edu
Squier
Waney
W
Eastman
James T
JT
D002555:Cerebrospinal Fluid / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D004388:Dura Mater / Q000033:anatomy & histology; D006408:Hematoma, Subdural / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008578:Meninges / Q000033:anatomy & histology* / Q000098:blood supply / Q000196:embryology / Q000503:physiopathology; D013355:Subdural Space / Q000033:anatomy & histology