The intracranial arachnoid mater
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REVIEW PAPER
The intracranial arachnoid mater A comprehensive review of its history, anatomy, imaging, and pathology Nimer Adeeb & Aman Deep & Christoph J. Griessenauer & Martin M. Mortazavi & Koichi Watanabe & Marios Loukas & R. Shane Tubbs & Aaron A. Cohen-Gadol
Received: 27 July 2012 / Accepted: 27 August 2012 / Published online: 8 September 2012 # Springer-Verlag 2012
Abstract Introduction The arachnoid mater is a delicate and avascular layer that lies in direct contact with the dura and is separated from the pia mater by the cerebrospinal fluid-filled subarachnoid space. The subarachnoid space is divided into cisterns named according to surrounding brain structures. Methods The medical literature on this meningeal layer was reviewed in regard to historical aspects, etymology, embryology, histology, and anatomy with special emphasis on the arachnoid cisterns. Cerebrospinal fluid dynamics are discussed along with a section devoted to arachnoid cysts. Conclusion Knowledge on the arachnoid mater and cerebrospinal fluid dynamics has evolved over time and is of great significance to the neurosurgeon in clinical practice. Keywords Meninges . Leptomeninges . Arachnoid mater . Intracranial . Anatomy . CSF . Arachnoid cysts . Arachnoid granulations . Villi
N. Adeeb : A. Deep : K. Watanabe : R. S. Tubbs (*) Pediatric Neurosurgery, Children’s Hospital, JFL Bld. 400 TCHA, 1600 7th Avenue South, Birmingham, AL 35233, USA e-mail: [email protected] C. J. Griessenauer : M. M. Mortazavi Division of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA M. Loukas Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada A. A. Cohen-Gadol Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, IN, USA
Introduction Ancient descriptions of the cranial meninges were limited to the dura mater and pia mater. At that time, the use of the word arachnoid was limited to web-shaped membranes found normally or pathologically in the body. The first description of an arachnoid membrane surrounding the brain can be traced back to Herophilus in the 3rd century B.C. Herophilus, the father of anatomy, was born in Chalcedon and moved to Alexandria early in his life, where, along with Erasistratus, he studied human anatomy for almost 40 years. For the first time in history, they performed systemic dissection and vivisection of the human body. These kind of examinations, although considered unethical, contributed to a huge amount of medical knowledge that has persisted until today. Regarding the nervous system, Herophilus studied and described the arachnoid mater and the ventricles (mainly the lateral and the fourth ventricles) and its linings, which he named “choroid meninx.” Although the presence of the arachnoid mater was outlined by Constantius Varolius [132] in 1573 and the atlas of Casserius [17] in 1627, its “discovery” is attributed to the efforts of Gerardus Blasius [14] in 1666 and Andreas Ottomar Goelicke [37] in 1697, who called it tertia cerebr
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