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

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

1. superior sagittal sinus(sinus sagittalis superior) - unpaired, runs along the midline of the cranial vault in the eponymous groove from the cockscomb, where they flow into the sinus veins of the nasal cavity, to the internal occipital protuberance, where the superior sagittal sinus joins 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 drain.

2. inferior sagittal sinus(sinus sagittalis inferior) - unpaired, located in the lower free edge of the crescent of the brain (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 direct 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 - lower 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 - upper stony sinus; 18 - transverse sinus; 19 - sink sinuses; 20 - cerebellum; 21 - straight sinus; 22 - crescent of the brain; 23 - superior sagittal sinus; 24 - a large cerebral vein; 25 - thalamus; 26 - inferior sagittal sinus

3. Direct sinus ( sinus rectus) - unpaired, stretches along the junction of the crescent of the brain and the cerebellum (see Fig. 1). In front, a large cerebral vein opens into it, from behind, the sinus connects to the transverse sinus.

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

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

1 - superior sagittal sinus; 2 - sink sinuses; 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 cerebellum tenon, in the occipital bone groove of the same name (Fig. 3). In front passes into 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 - wedge-parietal sinus; 6 - block nerve; 7 - ophthalmic nerve; 8 - maxillary nerve; 9 - trigeminal node; 10 - mandibular nerve; 11 - middle meningeal artery; 12 - abducens nerve; 13 - lower stony sinus; 14 - superior stony sinus, sigmoid sinus; 15 - basilar venous plexus; transverse sinus; 16 - cavernous venous sinus, sinus drain; 17 - anterior and posterior intercavernous sinuses; 18 - superior ophthalmic vein

6. Sigmoid sinus(sinus sigmoideus) - paired, located in the same groove of 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 view:

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

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

In the region of the clivus of the occipital bone, in the thickness of the dura lies basilar plexus. It connects to the occipital, inferior stony, 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 Turkish saddle (Fig. 5). In its cavity 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 and posterior). The upper and inferior ophthalmic vein, 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 (pulsating exophthalmos syndrome).

Rice. 5. Cross 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 - ophthalmic nerve; 9 - abducens nerve; 10 - block nerve; 11 - oculomotor nerve; 12 - cavernous sinus;

b - cross section of the cavernous sinus (scheme): 1 - pituitary gland; 2 - internal carotid artery; 3 - outer sheet of the hard shell of the brain; 4 - cavity of the cavernous sinus; 5 - trigeminal node; 6 - ophthalmic nerve; 7 - abducens nerve; 8 - lateral wall of the cavernous sinus; 9 - block 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 and 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. Falls 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 venous plexus round And oval holes- with the pterygoid venous plexus, and through the eye 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 cranial vault; the sigmoid sinus is connected by the mastoid emissary vein to the veins of the occiput; the transverse sinus has similar anastomoses with the occipital veins via 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 hard shell 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 the hard shell that form the sinus are tightly stretched and do not fall off. 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 bones of the skull, at the locations of the sinuses of the hard shell, there are corresponding grooves. There are the following sinuses of the hard shell of the brain (Fig. 165).

1. superior sagittal sinus,sinus sagittalis superior, located along the entire outer (upper) edge of the crescent of the brain, from the cockscomb 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 are lateral lacunae communicating with it, lacunae laterales. These are small cavities between the outer and inner layers (sheets) of the hard shell 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, the veins of the brain, and the diploic veins flow into them.

2. inferior sagittal sinus,sinus sagittalis inferior, is located in the thickness of the lower free edge of the falx cerebrum; it is much smaller than the top. 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 cerebrum fuses with the anterior edge of the cerebellum tenon.

3. straight sinus,sinus . rectus, located sagittally in the splitting of the cerebellar tentorium along the line of attachment of the falx cerebrum to it. The straight sinus connects the posterior ends of the superior and inferior sagittal sinuses. In addition to the inferior sagittal sinus, a large cerebral vein flows into the anterior end of the direct sinus. Behind the direct sinus flows into the transverse sinus, into its middle part, called the sinus drain. The posterior part of the superior sagittal sinus and the occipital sinus also flow here.

4. transverse sinus,sinus transverse, lies in the place of departure from the hard shell of the brain of the cerebellum. On the inner surface of the scales 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(confluence of sinuses), conftuens sinuum. On the right and left, the transverse sin ^ s 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 large occipital foramen, 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 of its side, and the upper end into the transverse sinus.

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

7cavernous sinus,sinus caverndsus, paired, located on the base of the skull on the side of the Turkish saddle. 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 Turkish saddle, in front of and behind the funnel of the pituitary gland. The sphenoid-parietal sinus and the superior ophthalmic vein flow into the anterior sections of the cavernous sinus.

8sphenoparietal sinus,sinus sphenoparietalis, paired, adjacent to the free posterior edge of the small wing of the sphenoid bone, in the splitting of the hard shell of the brain attached here.

9superior and inferior petrosal sinuses,sinus petrosus su perior 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 outflow tracts of venous blood from the cavernous sinus to the sigmoid. The right and left lower petrosal sinuses are connected by several veins lying in the splitting of the hard shell in the region of the body of the occipital bone, which are called the basilar plexus. This plexus connects through the foramen magnum with the internal vertebral venous plexus.

Allocate a number of major venous sinuses (sinuses) (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. Perhaps a slight deviation to the right, less often to the left of the midline. It is more typical of the posterior sinus. The width of the sinus is from 1 to 3 cm. Its shape is complicated due to 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 brain veins 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 transverse; 10 - confluens 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 greater falciform process of the meninges. Going from front to back and straying from a large vein of the brain (v. magna cerebri Galeni), it forms a direct venous sinus.

The direct sinus (sinus rectus) is incorporated in the princely part of the cerebellar plaque; 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 small falciform process of the meninges, follows from the large occipital foramen to the internal tuberosity of the occipital bone. Merging with the superior sagittal and rectus sinuses, it forms a certain expansion of the venous bed (confluens sinuum) in the region of the occiput.

The transverse sinus (sinus transversus) is laid in the transverse groove of the occipital bone, conducts blood from the place of venous fusion 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.

S-shaped sinus (sinus sigmoideus) follows the same groove, 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 to 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 side.

The cavernous sinus (sinus cavernosus) is a system of venous sinuses surrounding the Turkish saddle with the pituitary gland. The sinus got its name from the presence of connective tissue partitions in it. The cavernous sinus receives the ophthalmic veins. This makes it dangerous to develop purulent processes in the cavity of the orbit; infected thrombi of the ophthalmic vein are able to penetrate into the cavernous sinus. Blood from the cavernous sinus flows through the paired upper and lower stony sinuses (sinus pertrosus superior et inferior), located in the same grooves of the pyramid of the temporal bone, into the S-shaped sinuses.

In the thickness of the dura mater in the region of the cranial vault are the anterior, middle and posterior arteries and veins of the same name. The largest of the arteries is the middle - a. meningea media. Fracture of the skull bones is often accompanied by damage to the vessel with an outpouring of blood into the epidural space, which leads to compression of the medulla, causing a severe clinical picture. In these cases, ligation of the damaged artery is necessary.

The middle artery of the meninges departs from the internal maxillary artery and enters the cranial cavity through the spinous foramen. In the cranial cavity, the vessel follows the eponymous groove 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 then go up and backwards. The position of the branches of the artery is determined using the Cronlein scheme.

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

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

Venous sinuses

Cerebral veins

Section of the skull showing the sinuses of the dura mater

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

Anatomy

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

From the sinuses, blood enters 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 graduates.

Venous sinuses

superior sagittal sinus(lat. sinus sagittalis superior) - is located along the upper edge of the falciform process of the dura mater, ending behind 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) - extends along the lower edge of the sickle, merges into a straight sinus.
Direct sine(lat. sinus rectus) is located along the junction of the falciform process with the 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 transverse) - paired, located in the transverse groove of the bones of the skull, located along the posterior edge of the cerebellum. At the level of the internal occipital protrusion, the transverse sinuses communicate with each other. In the region 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 sickle of the cerebellum, spreading to the large occipital foramen, 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 (cavernous) sinus(lat. sinus cavernosus) - paired, located on the sides of the Turkish saddle. In the cavity of the cavernous sinus are 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. Cavernous sinuses are interconnected by intercavernous sinuses. Through the superior and inferior petrosal sinuses, they connect with the transverse and sigmoid sinuses, respectively.
Intercavity sinuses(lat. sinus intercavernosi) - are located around the Turkish saddle, forming a closed venous ring with the cavernous sinuses.
Sphenoparietal sinus(lat. sinus sphenoparietalis) - paired, goes along the small wings of the sphenoid bone, opening into the cavernous sinus.
superior petrosal sinus(lat. sinus petrosus superior) - paired, goes from the cavernous sinus along the upper petrous 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.

Clinical Significance

As a result of trauma to the dura mater, which may be due to a fracture of the bones of the skull, sinus thrombosis may develop. Also, sinus thrombosis can 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 (DAVMs), more often observed in the region of the transverse and sigmoid sinuses, less often in the superior sagittal, petrosal sinuses or the floor of the anterior cranial fossa (ethmoid DAVMs). DAVMs are formed against the background of degenerative changes in the vascular wall, due to injury or thrombosis of the sinuses. Of the direct DAVMs (or post-traumatic dural arteriovenous fistulas), the most common, due to the peculiarities of the anatomy, 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

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