Brain Cisterns Dr. Yaser Abdulghani AlQasimi, MBBS Radiology Demonstrator, KAU
Brain Meninges • 3 layer system of membranes which envelops the central nervous system. • Layers are: • Dura mater • Arachnoid mater • Pia mater
Cisterns • Cisterns are openings in the subarachnoid space of the brain created by a separation of the arachnoid and pia mater. These spaces are filled with CSF.
Brain Cisterns There are many cisterns in the brain, but the notable ones include: • Cisterna magna (cerebellomedullary). • Cisterna pontis (pontine cistern). • Interpeduncular cistern. • Quadrigeminal cistern (superior cistern). • Ambient cistern. • Cistern of the velum interpositum. • Suprasellar/Chiasmatic cistern. • Cistern of lamina terminalis. • Supracallosal cistern. • Sylvian cistern.
Cisterna Magna • Lies behind the medulla and below the cerebellar hemispheres. • Continuos with 4th ventricle through median aperture of Magendie. • Its lateral part contains the vertebral artery and its posterior inferior cerebellar branch.
Pontine Cistern • Lies between the pons and the clivus. • Receives CSF from lateral apertures of 4th ventricle (Luschka). • Continuous above with the interpeduncular cistern. • It contains the basilar artery and its pontine and labyrinthine branches.
Interpeduncular Cistern • Lies between the cerebral peduncles. • Continuous below with the pontine cistern, laterally with the ambient cisterns, and superiorly with the suprasellar cistern. • It contains the posterior part of the arterial circle of Willis.
Quadrigeminal Cistern • lies posterior to qudrigeminal plate of the midbrain and between the splenium above and the vermis below. • It is continuous with the interpeduncular cistern anteriorly through the ambient cisterns. • Contains the great cerebral vein of Galen.
Ambient Cistern • sheet like cistern that extend around both sides of midbrain between the interpeduncular cistern anteriorly and the qudrigeminal cistern posteriorly. • the posterior cerebral artery and the basal vein lie in the anterior part of each ambient cistern.
Suprasellar / Chiasmatic Cisterns • Suprasellar cistern lies above the pituitary fossa and is continuous posteriorly with the interpeduncular cistern and laterally with the sylvian cistern. • It contains the anterior part of the circle of Willis and the optic nerve as it passes to the chiasm. • Chiasmatic cistern is the part of suprasellar cistern that is anterior to the optic nerve.
Sylvian Cistern • This is the area of sylvian fissure.
Cistern of lamina terminalis / Pericallosal Cistern • The cistern of lamina terminalis is the superior extension of suprasellar and chiasmatic cisterns that extend to the superior surface of corpus callosum as the pericallosal (supracallosal) cistern. • Pericallosal cistern is continuous posteriorly with the quadrigeminal cistern. • It contains branches of the anterior cerebral artery.