Superior sagittal sinus. Sinuses of the dura mater Sinuses of the skull

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Sinuses of the dura mater(sinus durae matris). Sinuses are canals formed by splitting of the dura mater, usually at its attachment to the bones of the skull. The walls of the sinuses are covered from the inside with endothelium, dense, and do not collapse, which ensures free flow of blood.

1. Superior sagittal sinus(sinus sagittalis superior) - unpaired, runs along the midline of the cranial vault in the groove of the same name from the cock's crest, where they flow into the sinus veins of the nasal cavity, to the internal occipital protuberance, where the superior sagittal sinus connects with the transverse sinus (Fig. 1). The lateral walls of the sinus have numerous openings connecting its lumen with lateral lacunae (lacunae laterales), into which the superficial cerebral veins flow.

2. Inferior sagittal sinus(sinus sagittalis inferior) - unpaired, located in the lower free edge of the falx cerebri (Fig. 1). The veins of the medial surface of the hemispheres open into it. After connecting with the great cerebral vein, it passes into the straight sinus.

Rice. 1. Sinuses of the dura mater, side view:

1 - internal vein of the brain; 2 - superior thalamostriatal (terminal) vein of the brain; 3 - caudate nucleus; 4 - internal carotid artery; 5 - cavernous sinus; 6 - superior ophthalmic vein; 7 - vorticose veins; 8 - angular vein; 9 - inferior ophthalmic vein; 10 - facial vein; 11 - deep vein of the face; 12 - pterygoid venous plexus; 13 - maxillary vein; 14 - common facial vein; 15 - internal jugular vein; 16 - sigmoid sinus; 17 - superior petrosal sinus; 18 - transverse sinus; 19 — sinus drain; 20 - tentorium of the cerebellum; 21 - direct sinus; 22 - falx cerebri; 23 - superior sagittal sinus; 24 - great cerebral vein; 25 - thalamus; 26 - inferior sagittal sinus

3. Straight sinus (sinus rectus) - unpaired, stretches along the junction of the falx cerebellum and the tentorium cerebellum (see Fig. 1). The large cerebral vein opens into it in front, and the sinus connects with the transverse sinus behind.

4. Sinus drain (confluens sinuum) - the junction of the superior sagittal and direct sinuses (Fig. 2); located at the internal occipital protrusion.

Rice. 2. Sinuses of the dura mater, posterior view:

1 - superior sagittal sinus; 2 - sinus drain; 3 - transverse sinus; 4 - sigmoid sinus; 5 - occipital sinus; 6 - vertebral artery; 7 - internal jugular vein

5. Transverse sinus(sinus trasversus) - paired, located in the posterior edge of the tentorium of the cerebellum, in the groove of the same name in the occipital bone (Fig. 3). Anteriorly it becomes the sigmoid sinus. The occipital cerebral veins flow into it.

Rice. 3. Sinuses of the dura mater, top view:

1 - pituitary gland; 2 - optic nerve; 3 - internal carotid artery; 4 - oculomotor nerve; 5 - sphenoparietal sinus; 6 - trochlear nerve; 7 - optic nerve; 8 - maxillary nerve; 9 - trigeminal node; 10 - mandibular nerve; 11 - middle meningeal artery; 12 - abducens nerve; 13 - inferior petrosal sinus; 14 - superior petrosal sinus, sigmoid sinus; 15 - basilar venous plexus; transverse sinus; 16 - cavernous venous sinus, sinus drainage; 17 - anterior and posterior intercavernous sinuses; 18 - superior ophthalmic vein

6. Sigmoid sinus(sinus sigmoideus) - paired, located in the groove of the same name in the occipital bone and opens into the superior bulb of the internal jugular vein (Fig. 4). The temporal cerebral veins drain into the sinus.

Rice. 4. Transverse and sigmoid sinuses, posterior and lateral views:

1 - anterior semicircular duct; 2 - vestibulocochlear nerve; 3 - trigeminal nerve; 4 - genu of the facial nerve; 5 - auricle; 6 - cochlear duct; 7 - cochlear nerve; 8 - lower part of the vestibular nerve; 9 - internal jugular vein; 10 - upper part of the vestibular nerve; 11 - lateral semicircular duct; 12 - posterior semicircular duct; 13 - sigmoid sinus; 14 - transverse sinus; 15 — sinus drain; 16 - superior petrosal sinus; 17 - cerebellum

7. Occipital sinus(sinus occipitalis) - unpaired, small, lies in the falx of the cerebellum along the internal occipital crest, drains blood from the sinus drainage (see Fig. 2-4). At the posterior edge of the foramen magnum, the sinus bifurcates. Its branches surround the opening and flow into the terminal segments of the right and left sigmoid sinuses.

In the region of the clivus of the occipital bone, in the thickness of the dura mater lies basilar plexus (plexus basilaris). It connects with the occipital, inferior petrosal, cavernous sinuses and the internal venous vertebral plexus.

8. Cavernous sinus(sinus cavernosus) - paired, the most complex in structure, lies on the sides of the sella turcica (Fig. 5). In its cavity there is the internal carotid artery, and in the outer wall - the first branch of the V pair of cranial nerves, III, IV, VI cranial nerves. The cavernous sinuses are connected by the anterior and posterior intercavernous sinuses (sinus intercavernosus anterior et posterior). The superior and inferior ophthalmic veins, inferior veins of the brain. When the cavernous part of the internal carotid artery is damaged, anatomical conditions are created for the formation of arteriovenous carotid-cavernous aneurysms (pulsatile exophthalmos syndrome).

Rice. 5. Transverse section of the cavernous sinus (preparation by A.G. Tsybulkin):

a — histotopogram in the frontal plane: 1 — optic chiasm; 2 - posterior communicating artery; 3 - internal carotid artery; 4 - pituitary gland; 5 - sphenoid sinus; 6 - nasal part of the pharynx; 7 - maxillary nerve; 8 - optic nerve; 9 - abducens nerve; 10 - trochlear nerve; 11 - oculomotor nerve; 12 - cavernous sinus;

b — cross-section of the cavernous sinus (diagram): 1 — pituitary gland; 2 - internal carotid artery; 3 - outer layer of the dura mater of the brain; 4 - cavity of the cavernous sinus; 5 - trigeminal node; 6 - optic nerve; 7 - abducens nerve; 8 - lateral wall of the cavernous sinus; 9 - trochlear nerve; 10 - oculomotor nerve

9. Sphenoparietal sinus(sinus sphenoparietalis) lies along the edges of the small wings of the sphenoid bone. Opens into the cavernous sinus.

10. Superior and inferior petrosal sinuses (sinus petrosi superior et inferior) - paired, lie along the edges of the pyramid of the temporal bone along the grooves of the same name, they connect the sigmoid and cavernous sinuses. Flows into them superficial middle cerebral vein.

The venous sinuses have numerous anastomoses through which a roundabout outflow of blood from the cranial cavity is possible, bypassing the internal jugular vein: the cavernous sinus through venous plexus of the carotid canal, surrounding the internal carotid artery, connected to the veins of the neck, through round venous plexus And oval holes- with the pterygoid venous plexus, and through the ophthalmic veins - with the veins of the face. The superior sagittal sinus has numerous anastomoses with the parietal emissary vein, diploic veins and veins of the calvarium; the sigmoid sinus is connected by the mastoid emissary vein to the veins of the back of the head; The transverse sinus has similar anastomoses with the occipital veins through the occipital emissary vein.

Human anatomy S.S. Mikhailov, A.V. Chukbar, A.G. Tsybulkin

Sinuses of the dura mater of the brain. The sinuses (sinuses) of the dura mater of the brain, formed by splitting the shell into two plates, are channels through which venous blood flows from the brain into the internal jugular veins (Fig. 164).

The sheets of hard shell that form the sinus are stretched tightly and do not collapse. Therefore, on the cut, the sinuses gape; Sinuses do not have valves. This structure of the sinuses allows venous blood to flow freely from the brain, regardless of fluctuations in intracranial pressure. On the inner surfaces of the skull bones, at the locations of the sinuses of the dura mater, there are corresponding grooves. The following sinuses of the dura mater of the brain are distinguished (Fig. 165).

1. Superior sagittal sinus,sinus sagittalis superior, located along the entire outer (upper) edge of the falx cerebri, from the cock's crest of the ethmoid bone to the internal occipital protrusion. In the anterior sections, this sinus has anastomoses with the veins of the nasal cavity. The posterior end of the sinus flows into the transverse sinus. To the right and left of the superior sagittal sinus there are lateral lacunae communicating with it, lacunae laterales. These are small cavities between the outer and inner layers (sheets) of the dura mater of the brain, the number and size of which are very variable. The cavities of the lacunae communicate with the cavity of the superior sagittal sinus; the veins of the dura mater of the brain, cerebral veins and diploic veins flow into them.

2. inferior sagittal sinus,sinus sagittalis inferior, located in the thickness of the lower free edge of the falx cerebri; it is significantly smaller than the top one. With its posterior end, the inferior sagittal sinus flows into the straight sinus, into its anterior part, in the place where the lower edge of the falx cerebellum fuses with the anterior edge of the tentorium cerebellum.

3. Direct sinesinus . rectus, located sagittally in the split of the tentorium cerebellum along the line of attachment of the falx cerebellum to it. The straight sinus connects the posterior ends of the superior and inferior sagittal sinuses. In addition to the inferior sagittal sinus, the great cerebral vein drains into the anterior end of the straight sinus. At the back, the straight sinus flows into the transverse sinus, into its middle part, called the sinus drainage. The posterior part of the superior sagittal sinus and the occipital sinus also flow here.

4. Transverse sinus,sinus transversus, lies in the place where the tentorium cerebellum extends from the dura mater of the brain. On the inner surface of the squama of the occipital bone, this sinus corresponds to a wide groove of the transverse sinus. The place where the superior sagittal, occipital and straight sinuses flow into it is called sinus drain(fusion of sinuses), conftuens sinuum. On the right and left, the transverse sinus continues into the sigmoid sinus of the corresponding side,

5occipital sinus,sinus occipitalis, lies at the base of the falx cerebellum. Descending along the internal occipital crest, it reaches the posterior edge of the foramen magnum, where it divides into two branches, covering this foramen from behind and from the sides. Each of the branches of the occipital sinus flows into the sigmoid sinus on its side, and the upper end into the transverse sinus.

6sigmoid sinus,sinus sigmoideus (paired), located in the groove of the same name on the inner surface of the skull, has an S-shape. In the area of the jugular foramen, the sigmoid sinus passes into the internal jugular vein.

7cavernous sinus,sinus caverndsus, paired, located at the base of the skull on the side of the sella turcica. The internal carotid artery and some cranial nerves pass through this sinus. This sinus has a very complex structure in the form of caves communicating with each other, which is why it got its name. Between the right and left cavernous sinuses there are communications (anastomoses) in the form of anterior and posterior intercavernous sinuses, sinus intercavernosi, which are located in the thickness of the diaphragm of the sella turcica, in front and behind the pituitary infundibulum. The sphenoparietal sinus and the superior ophthalmic vein flow into the anterior parts of the cavernous sinus.

8Sphenoparietal sinus,sinus sphenoparietalis, paired, adjacent to the free posterior edge of the lesser wing of the sphenoid bone, in the splitting of the dura mater of the brain attached here.

9Superior and inferior petrosal sinuses,sinus petrosus su period et sinus petrosus inferior, paired, lie along the upper and lower edges of the pyramid of the temporal bone. Both sinuses take part in the formation of pathways for the outflow of venous blood from the cavernous sinus to the sigmoid sinus. The right and left inferior petrosal sinuses are connected by several veins lying in the cleft of the dura in the area of the body of the occipital bone, which are called the basilar plexus. This plexus connects through the foramen magnum to the internal vertebral venous plexus.

There are a number of main venous sinuses (sines) (Fig. 21).

The superior sagittal sinus (sinus sagittalis superior) runs along the midline of the skull, gradually expanding from the blind foramen (foramen coecum) to the internal tuberosity of the occipital bone. There may be a slight deviation to the right, less often to the left, from the midline. It is more typical for the posterior portion of the sinus. The width of the sinus is from 1 to 3 cm. Its shape is complicated by lateral protrusions (lacuna lateralis), the depth of which is 2.5-3 cm. When trepanning the skull, the surgeon must take into account the position of the venous sinus and its lacunae. The veins of the brain emissaria parietalis flow into the sinus, communicating with the veins of the cranial vault, and emissaria foraminis coeci, anastomosing with the veins of the nasal cavity.

Rice. 21. Sinuses of the dura mater:
1- sinus sagittalis superior; 2 - sinus sagittalis inferior; 3 - v. cerebri magna; A - sinus rectus; 5 - v. ophthalmica superior; 6 - v. opthalmica inferior; 7 - sinus cavernosus; 3 - sinus petrosus superior et inferior; 9 - sinus transversus; 10 - confluence sinum; 11 - sinus occipitalis; 12 - sinus sigmoideus; 13 - v. jugularis interna; 14 - v. retromandibularis; 15 - v. facialis; 16 - pi. pterygoideus; 17 - v. facialis; 15 - v. nasalis; 19 - vv. cerebri; 20 - v. temporalis superficialis; 21 - tentorium cerebelli; 22 - falx cerebri; a-v. emissaria parietale; b - v. emissaria occipitale; in - v. emissaria mastoideum.

The inferior sagittal sinus (sinus sagittalis inferior) is located along the free lower edge of the large falciform process of the meninges. Going from front to back and meeting the great vein of the brain (v. magna cerebri Galeni), it forms the direct venous sinus.

The direct sinus (sinus rectus) is located in the princely part of the cerebellar tentorium; at the internal tuberosity of the occipital bone it merges with the superior sagittal sinus.

The occipital sinus (sinus occipitalis) is located on the line of attachment to the bone of the cerebellar or lesser falciform process of the meninges, extending from the foramen magnum to the internal tuberosity of the occipital bone. Merging with the superior sagittal and straight sinuses, it forms a slight expansion of the venous bed (confluens sinuum) in the region of the occipital protuberance.

The transverse sinus (sinus transversus) is located in the transverse groove of the occipital bone, conducts blood from the site of venous confluence forward to the pyramid of the temporal bone, where it passes into the S-shaped sinus. On the skin, the projection of the transverse sinuses corresponds to the line following from the external tuberosity of the occipital bone to the auditory canals.

The S-shaped sinus (sinus sigmoideus) follows the groove of the same name, located on the inner surface of the mastoid process, to the jugular foramen at the base of the skull. It conducts blood from the transverse sinus into the internal jugular vein. Sinus through v. emissaria mastoidea anastomoses with the occipital vein. On the right side, the S-shaped sinus is usually wider and deeper into the bone than on the left.

The cavernous sinus (sinus cavernosus) is a system of venous sinuses surrounding the sella turcica with the pituitary gland. The sinus gets its name from the presence of connective tissue septa in it. The cavernous sinus receives the orbital veins. This makes the development of purulent processes in the orbital cavity dangerous; infected ophthalmic vein thrombi are able to penetrate the cavernous sinus. Blood from the cavernous sinus flows through the paired superior and inferior petrosal sinuses (sinus pertrosus superior et inferior), located in the grooves of the same name in the pyramid of the temporal bone, into the S-shaped sinuses.

The anterior, middle and posterior arteries and veins of the same name pass through the thickness of the dura mater in the area of the cranial vault. The largest of the arteries is the middle one - a. meningea media. A fracture of the skull bones is often accompanied by damage to a vessel with bleeding into the epidural space, which leads to compression of the medulla, giving rise to a severe clinical picture. In these cases, ligation of the damaged artery is necessary.

The middle meningeal artery arises from the internal maxillary artery and enters the cranial cavity through the foramen spinosum. In the cranial cavity, the vessel follows the groove of the same name on the inner surface of the temporal and then the parietal bones. With a short common trunk, it rises slightly above the zygomatic arch and is divided into anterior and posterior branches, which are then directed upward and posteriorly. The position of the artery branches is determined using the Kronlein diagram.

The nerves that innervate it also pass through the dura mater. They belong to the trigeminal nerve system.

Under the dura mater there is a gap (spatium subdurale), filled with loose fiber with a small amount of serous fluid.

Venous sinuses

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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Superior sagittal sinus. Sinuses of the dura mater Sinuses of the skull

Anatomy

Venous sinuses

Clinical significance

Images

see also

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