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


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Introduction

The dura mater frequently gets referred to as merely the dura. It is just one of the layers of connective tissue that make up the meninges of the brain (pia, arachnoid, and also dura, from inside to outside). It is the outermany layer of the three meninges that surround and protect the brain and spinal cord. The dura mater is made up of fibroblasts and large amounts of extracellular collagen.<1>

The dura mater is composed of two layers: the periosteal/endosteal layer and the meningeal layer. The dural venous sinuses are in between these two layers. The dura folds to create septa that develop the falx cerebri, tentorium cerebelli, falx cerebelli, and also diaphragma sellae.


Structure and Function

The periosteal or endosteal layer of the dura mater is simply a layer of periosteum that covers the inner surface of the skull. The layer does not extfinish beyond the foramen magnum to come to be contiguous via the dura mater of the spinal cord. The spinal cord dura mater has actually no periosteal layer.

In the brain, the periosteal layer provides a tubular sheath-favor spanning for the cranial nerves as they pass via the different foramina of the skull. As shortly as the cranial nerves leave the foraguys, the periosteal layer fprovides through the epineurium of nerves.

The meningeal layer of the dura mater is a sturdy, dense fibrous membrane that passes with the foramales magnum and also is constant via the dura mater of the spinal cord. The meningeal layer of the dura mater creates numerous dural folds that divide the cranial cavity into freely communicating spaces. The feature of the dural folds is to limit the rotational displacement of the brain.

The folds include the following:


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

Potential Spaces

The dura mater serves the complying with function:<5>


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

Embryology

The dural mater originates from the somitic mesoderm, which condenses roughly the neural tube quickly after the neural tube closes at the embryonic day 9, while the pia and arachnoid (leptomeninges) originate from the neural crest.<5><6>

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

The initially of the dural procedures to develop is the tentorium cerebelli.<6>

Research has displayed that fetal meninges play a crucial duty in the time of brain advancement. The dura mater influences the proliferation and also migration of neural progenitors cells and also neurons in the prosencephalon (forebrain) and also rhombencephalon (hindbrain).<7>


Blood Supply and also Lymphatics

The dura mater receives vascular supply from the following branches:


Internal carotid artery

Surgical Considerations

The dura mater is very essential to the clinician bereason it is a obstacle to the interior environment of the brain, and also surgically, the neurosurgeon and also clinician who interpret imaging have to understand its anatomy.<9>

Dural tears are a regular complication of lumbar spine surgical procedure.<10>

Lumbar Puncture

Diagnostic lumbar puncture is just one of the the majority of commonly performed invasive tests in clinical medication.<11> Some common indications for lumbar puncture include evaluation of inflammatory or contagious disease of the nervous mechanism (viral, bacterial, tuberculous, or fungal meningitis) and acute headache.

Knowledge of the anatomy of the lumbar spine is crucial for anyone perdeveloping a lumbar puncture. The lumbar puncture needle transverses the complying with frameworks in order: skin, subcutaneous tproblem, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural area, dura mater, arachnoid mater, and ultimately the subarachnoid area where cerebrospinal liquid (CSF) is stored.<11>


Clinical Significance

After head trauma, a patient may build an epidural (extradural) or subdural hematoma. The hematoma have the right to bring about a rapid rise in intracranial push, and death deserve to result if not treated.

Epidural Hematoma

In an epidural hematoma, the arterial blood collects in between the endosteal layer of the dura and the skull. The vessel generally associated is the middle meningeal artery (MMA), which might be ruptured or torn as a result of blunt or penetrating brain trauma.<12><3> The middle meningeal artery is a tributary of the maxillary artery, and also the maxillary artery is one of the terminal branches of the external carotid artery.

Subdural Hematoma

In a subdural hematoma, tbelow is a repertoire of venous blood in between the dura and also the arachnoid mater. The hematoma generally is because of injury or rupture of the subdural veins as they empty right into the dural venous sinuses. Subdural hematoma arises from the rupture of bridging veins, generally from head trauma. Due to the fact that the venous push in the veins is low, the hematoma is not frequently big, and also development is not quick. An boost in intracranial press ca rise the price of bleeding from the ruptured bridging veins.<13> The anatomy of the bridging vein makes it at risk to tearing within the border cell layer of the dura mater.<13>

Subdural bleeding (SDB) in babies is taken into consideration a critical symptom of nonaccidental head injury.

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The Sensitivity of the Dural Mater

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