OBJECTIVE: Headache and postcraniotomy pain can be disabling. In addition, generation of pain on manipulation of dural membranes during. Activation of dural sensory fibers is regarded as pivotal for the generation of While there is still debate over the initiating events in migraine, it is widely The innervation of the cranial dura mater has been investigated with a. Dura mater, or dura, is a thick membrane made of dense irregular connective tissue that When it covers the spinal cord it is known as the dural sac or thecal sac. The innervation for the infratentorial dura mater are via upper cervical nerves. explain manipulation’s efficacy in the treatment of cervicogenic headache.

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Several previous reports support the presence of the nervus spinosus NSwhich comprises meningeal branches from the maxillary and mandibular trigeminal divisions as a dense plexus along the MMA in the middle cranial fossa Messlinger et al. This means that you will not need to remember your user name and password in the future and you will be able to login with the account you choose to sync, with the click of a button.

Today the same proviso might be applied, at least to surgical remedies. Background During endovascular Onyx embolization for intracranial dural arteriovenous fistula, a trigemino-cardiac reflex has been observed 12. Distinct bundles of the NS running along the course of the frontal branches of the MMA were present in Suggest a Research Topic.

Subarachnoid hemorrhage in the rat substantially reduced the SP-immunoreactive nerve fibers of the dura mater, but left the CGRP-immunoreactive innervation unchanged. Synonyms or Alternate Spellings: Stimulation of the middle meningeal artery leads to Fos expression in the trigeminocervical nucleus: Spinoreticular tract Spino-olivary tract.

Innervation of the Cerebral Dura Mater

A rupture of a bridging vein causes a subdural hematoma. B Medial view of the middle cranial fossa.


The dura mater is the outmost layer of the intracranial meninges that consist of inner meningeal and heaeache periosteal layers Kemp et al. Related Radiopaedia articles Anatomy: Large areas of the axon branches are not covered by Schwann cell cytoplasm.

Within the dura mater this receptor type is mainly distributed at locations where the superior cerebral veins empty into the sinus, and at the confluences of sinuses.

Is headafhe a correlation between spreading depression, neurogenic inflammation, and nociception that might cause migraine headache? Clinical importance of the middle meningeal artery.

In the same way, CGRP is preferentially released in subarachnoid hemorrhage. The cerebral dura mater is richly innervated by afferent nerve fibers, most of which originate in the ipsilateral trigeminal ganglion, and by sympathetic fibers predominantly arising from the ipsilateral superior cervical ganglion 34. Triptan-induced enhancement of neuronal nitric oxide synthase in trigeminal ganglion dural afferents underlies increased responsiveness to potential migraine triggers.

Cerebellar tonsillar ectopia, or Chiariis a condition that was previously thought to be congenital but can be induced by trauma, particularly whiplash trauma. Anatomical terminology [ ninervation on Wikidata ]. The entire length of the MMA in the middle cranial fossa, rural bifurcation point of the frontal and parietal branches of the MMA, the location and number of the main bundle of the nerve fibers crossing the wall of the MMA, and the number of origins of the nerve bundle were also measured.

The dura separates into two layers at dural reflections also known as dural foldsplaces where the inner dural layer is reflected as sheet-like protrusions into the cranial cavity. Afferent nerve fibers of the cerebral dura mater The cerebral dura mater is richly innervated by afferent nerve fibers, most of which originate in the ipsilateral trigeminal ganglion, and by sympathetic fibers predominantly arising from the ipsilateral superior cervical ganglion 34.

These bundles generally coursed alongside the frontal branches of the MMA at a certain distance from the wall of the artery, parallel to the lateral margin of the middle meningeal vein Figure 3.


Levy D, Strassman AM. It has been shown that the trigeminal innervation of the cerebral circulation preferentially employs calcitonin gene-related peptide CGRP in favor of SP 31 B Magnified views of the dotted boxes in A.

After losing the myelin sheath the unmyelinated branches of the A-fiber mix up with the C-fibers.

Mast cells were also identified in the falx cerebri and tentorium cerebelli, but were absent in the dura over the sinus. Meningeal nerve fibers immunoreactive for substance P SPneurokinin A, and calcitonin gene-related peptide CGRP are thought to belong to the afferent sensory system, and nerve fibers immunopositive for neuropeptide Y NPY are most likely of sympathetic origin while those immunoreactive for vasoactive intestinal peptide VIP are of parasympathetic origin.

The interface with the frontal branches of the MMA and the sphenoparietal sinus coincides with the pterion green linewhich is the region where the frontal Fparietal Psphenoid S and squamous parts of the temporal bones T join together.

Brain imaging correlates of peripheral nerve stimulation. Received Feb 22; Accepted Apr Increased responses in trigeminocervical nociceptive neurons to cervical input after stimulation of the dura mater.

Innervation of the Cerebral Dura Mater

Falx cerebri Tentorium cerebelli Falx cerebelli Diaphragma sellae Trigeminal hewdache. Trigemino-cardiac reflex in embolization of intracranial dural arteriovenous fistula. Purchase access Subscribe now. Arachnoid granulation Arachnoid trabeculae. Our aim was to review fhe literature regarding the innervation of the cranial dura mater and provide surgical case illustrations to highlight the relevance of such innervation to the neurosurgeon.

The dura-muscular, dura-ligamentous connections in the upper cervical spine and occipital areas may provide anatomic and physiologic answers to the cause of the cervicogenic headache.