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Subarachnoid Spaces/Cisterns

Main Text

TERMINOLOGY

Abbreviations

• Subarachnoid spaces (SASs)

Definitions

• SASs: Cerebrospinal fluid-filled spaces between pia, arachnoid; expand at base of brain, around brainstem, tentorial incisura
• Liliequist membrane: Thin arachnoid membrane separates suprasellar, interpeduncular, and prepontine cisterns
• Velum interpositum: Double layer of pia (tela choroidea), result of folding of brain where hemispheres overgrow diencephalon, forms velum interpositum, which may remain open and communicate posteriorly with quadrigeminal cistern (cavum veli interpositi)
• Choroidal fissure: Narrow, pial-lined channel between SAS and ventricles; site of attachment of choroid plexus in lateral ventricles

GROSS ANATOMY

Overview

• Numerous trabeculae, septa, membranes cross SAS → create smaller compartments termed cisterns

Liliequist membrane separates suprasellar, interpeduncular, and prepontine cisterns

Anterior/lateral pontine, medial/lateral pontomedullary membranes separate posterior fossa cisterns
• All cranial nerves, major arteries/veins traverse cisterns
• All structures within cisterns invested with thin pial-like layer of cells
• All SAS cisterns communicate with each other and with ventricular system (through foramina of Magendie and Luschka)
• Cisterns provide natural pathways for disease spread as well as surgical approaches
• SAS cisterns divided into supra- and peritentorial, infratentorial groups
• Sulci separate gyri, fissures separate hemispheres/lobes

IMAGING ANATOMY

Overview

• Supratentorial/peritentorial cisterns

Suprasellar cistern : Superior to pituitary gland

Interpeduncular cistern : Between cerebral peduncles, Liliequist membrane

Ambient (perimesencephalic) cisterns : Wrap around midbrain, connect suprasellar, quadrigeminal cisterns

Quadrigeminal cistern : Under corpus callosum splenium, behind pineal gland, tectum; continuous anteriorly with velum interpositum

Cistern of velum interpositum : Formed by double layers of tela choroidea (pia), lies above 3rd ventricle; communicates posteriorly with quadrigeminal cistern
• Infratentorial (posterior fossa) cisterns

Midline (unpaired)

– Prepontine cistern : Between upper clivus, anterior pons

– Premedullary cistern : From pontomedullary junction above to foramen magnum below; between lower clivus and medulla

– Superior cerebellar cistern : Between upper vermis, straight sinus

– Cisterna magna : Between medulla (anterior) and occiput (posterior), below/behind inferior vermis

Lateral (paired)

– Cerebellopontine cistern : Between anterolateral pons/cerebellum, petrous temporal bone

– Cerebellomedullary cistern (sometimes included as lower cerebellopontine cistern): From dorsal margin of inferior olive laterally around medulla
• Fissures

Interhemispheric fissure : Longitudinal cerebral fissure separates hemispheres

– Inferior part contains cistern of lamina terminalis; upper part contains pericallosal cistern

Sylvian (lateral) fissure : Separates frontal, temporal lobes anteriorly, courses laterally to cover insula

Internal Contents

• Supratentorial/peritentorial cisterns

Suprasellar cistern : Infundibulum, optic chiasm, circle of Willis

Interpeduncular cistern : Oculomotor nerves (CNIII), basilar artery (BA) bifurcation, posterior thalamoperforating arteries

Ambient cisterns : Trochlear nerves (CNIV), P2 posterior cerebral artery (PCA) segments and branches, superior cerebellar arteries (SCAs), basal veins of Rosenthal

Quadrigeminal cistern : Pineal gland, trochlear nerves (CNIV), P3 PCA segments, medial and lateral posterior choroidal arteries, vein of Galen (VofG) + tributaries

Cistern of velum interpositum : Internal cerebral veins (ICVs), MPChAs
• Infratentorial cisterns

Prepontine cistern : BA, anterior inferior cerebellar artery (AICA), CNV, and CNVI

Premedullary cistern : Vertebral arteries (VAs), anterior spinal artery, posterior inferior cerebellar artery (PICAs), CNXII

Superior cerebellar cistern : SCA branches, superior vermian and precentral cerebellar veins

Cisterna magna : Cerebellar tonsils (often have dense trabecular attachments), tonsillohemispheric PICA branches

Cerebellopontine cistern : CNV, CNVII, and CNVIII; AICA; petrosal vein

Cerebellomedullary cistern : CNIX, CNX, and CNXI

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Mar 13, 2021 | Posted by admin in NUCLEAR MEDICINE | Comments Off

Main Text

TERMINOLOGY

Abbreviations

GROSS ANATOMY

Overview

IMAGING ANATOMY

Overview

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Subarachnoid Spaces/Cisterns

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Definitions

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