venous dural sinuses and cavenous venous sinus

venous dural sinuses and cavenous venous sinus

1. VENOUS SINUSES IN DURA MATER & CAVERNOUS SINUS PRESENTED BY: DR. URVASHI SODVADIA DEPT OF CONSERVATIVE DENTISTRY & ENDODONTICS

2. CONTENTS Brief Introduction of meninges Structure of dura mater Introduction of venous sinuses Cavernous sinus Clinical aspect Drainage of venous sinuses Summary

3. MENINGES DURA MATER ARACHNOID MATER PIA MATER

4. DURA MATER Outer most layer Latin meaning : “hard mother” Two layers: Periosteal layer Meningeal layer Subdural space Epidural space

5. FOUR DURAL INFOLDING : Falx cerebri Tentorium cerebelli Falx cerebelli Diaphragma celli Dural venous sinuses

6. SPINAL DURA MATER

7. FALX CEREBRI LARGEST dural infolding Sickle shaped Separates cerebral hemispheres Attachments

8. Superior Sagittal Sinus Inferior Sagittal Sinus Straight Sinus Confluence of Sinuses

9. TENTORIUM CEREBELLI “TENT OF CEREBELLUM” Straight sinus Relations

10. Superior Petrosal Sinus Transverse Sinus

11. CLINICAL ASPECTS Epidural haematoma (middle meningeal artery) Subdural haematoma (superior cerebral vein)

12. ARACHNOID MATER Loosely surrounds the brain without dipping into sulci Subarachnoid space contains CSF Arachnoid villi Arachnoid granulation

13. Absorb CSF

14. PIA MATER Innermost layer “TENDER MOHER” Highly vascular, impermeable to fluid Arachnoid trabeculae MENINGITIS

15. VENOUS SINUSES

16. ARTERIAL SUPPLY VENOUS SUPPLY MAINLY BY 2 SYSTEMS : Internal carotid system Vertebral basillary system Does not follow the arterial supply ! Drains by “ DURAL VENOUS SINUS” BRAIN ARTERIAL SUPPLY BRAIN

17. VENOUS SINUSES Intracranial venous channels lined by endothelium No muscles No valves Communicates with veins outside skull through “ Emissary veins” 23 venous sinuses : 8 – Paired, 7 – Unpaired VENOUS SINUSES

18. Paired Venous Sinus Unpaired Venous Sinus Cavernous sinus Superior petrosal sinus Inferior petrosal sinus Transverse sinus Sigmoid sinus Sphenoparietal sinus Petrosquamous sinus Middle meningeal sinus/veins Superior sagittal sinus Inferior sagittal sinus Straight sinus Occipital sinus Anterior intracavernous sinus Posterior intracavernous sinus Basilar plexus of veins

19. Larger venous space situated into middle cranial fossa ,on either side of body of sphenoid bone Interior is divided into number of spaces or caverns by trabeculae CAVERNOUS SINUS

20. R L M F MENINGEAL DURA MATER ENDOSTEAL DURA MATER 2 cm 1 cm ATTACHMENTS

21. RELATIONS SUPERIORLY Olfactory tract Optic tract Optic chiasma Anterior perforated substances

22. INFERIORLY

23. MEDIALLY

24. LATERALLY Temporal lobe with Uncus

25. POSTERIORLY ANTERIORLY

26. STRUCTURE WITHIN LATERAL WALL OF SINUS

27. III IV V

28. THROUGH CENTER OF SINUS

29. Internal carotid artery VI

30. TRIBUTARIES OR INCOMING CHANNELS FROM ORBIT

31. FROM BRAIN & MENINGES Superficial middle cerebral vein Superficial middle cerebral vein Sphenoparietal sinus &middle meningeal vein

32. DRAINING CHANNELS OR COMMUNICATIONS superior petrosal sinus Transverse sinus Inferior petrosal sinus

33. PTERYGOID VENOUS PLEXUS SUPERIOR OPHTHALMIC VEIN ANGULAR VEIN

34. CLINICAL ANATOMY OF CAVERNOUS SINUS THROMBOSIS OF CAVERNOUS SINUS

35. ETIOLOGY

36. NERVOUS SYMPTOMS VENOUS SYMPTOMS Severe pain Headache III nerve IV nerve VI nerve Edema of eyelid,cornea & root of nose exophthalmos Known site of infection “EAGLETON CRITERIA”

37. CAROTID CAVERNOUS FISTULA

38. PULSATING EXOPHTHALMOS: eyeball protrudes and pulsates with each heart beat.

39. THANK YOU!