CSF cisterns

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CSF cisterns

  1. 1. DR/ Hytham Nafady
  2. 2. Cistern • Widening of subarachnoid space created by separation of pia and arachnoid. Dura Pia Arachnoid adherent to the skull adherent to the brain surface covers only superficial surface of the brain
  3. 3. Cistern • Widening of subarachnoid space created by separation of pia and arachnoid. Subarachnoid hemorrhage
  4. 4. P M IP CH SC CM VI Q PC LT
  5. 5. P M IP CH SC CM VI Q PC LT
  6. 6. P M CH CM VI PC LT
  7. 7. Perimesencephalic cistern 1. Interpeduncular C. 2. Crural C. 3. Ambient C. 4. Quadrigeminal C.
  8. 8. Perimesencephalic cistern 1. Interpeduncular C. 2. Crural C. 3. Ambient C. 4. Quadrigeminal C.
  9. 9. Perimesencephalic cistern 1. Interpeduncular C. 2. Crural C. 3. Ambient C. 4. Quadrigeminal C.
  10. 10. Perimesencephalic cistern 1. Interpeduncular C. 2. Crural C. 3. Ambient C. 4. Quadrigeminal C.
  11. 11. Perimesencephalic cistern 1. Interpeduncular C. 2. Crural C. 3. Ambient C. 4. Quadrigeminal C.
  12. 12. CSF cisterns Median un-paired cisterns Para-median paired cisterns 1-Premedullary 12-Inferior CP angle 2-Prepontine 13-Superior CP angle 3-Interpeduncular 14-Crural 4-Chiasmatic 15-ambient 5-Lamina terminalis 16-Carotid 6-Pericallosal 17-sylvian 7-Quadrigeminal 8-Vellum interpositum 9-Superior cerebellar 10-Cisterna magna 11-Vallecula
  13. 13. Medullary cistern premedullary cistern
  14. 14. Medullary cistern
  15. 15. PICA Cn12 VA
  16. 16. Pontine cistern pre-pontine cistern
  17. 17. Pontine cistern
  18. 18. Pontine cistern Basilar A Ant. Pontomesencephalic V Petrosal V Superior petrosal sinus
  19. 19. Pontine cistern
  20. 20. Pontine cistern AICA BA Cn6 Cn6 BA
  21. 21. Pre-pontine arachnoid cyst
  22. 22. Interpeduncular cistern basal cistern
  23. 23. Interpeduncular cistern
  24. 24. Interpeduncular cistern Cn 3 Interpeduncular cistern
  25. 25. Interpeduncular cistern
  26. 26. Basal v. Interpeduncular V DMCV Ponto- mesencephalic V Basilar A. Interpeduncular V DMCV
  27. 27. Chiasmatic cistern Suprasellar cistern
  28. 28. Chiasmatic cistern Suprasellar cistern
  29. 29. Suprasellar arachnoid cyst
  30. 30. Liliequist membrane The Liliequist membrane is the arachnoid membrane separating the chiasmatic and interpeduncular cisterns.
  31. 31. Liliequist membrane
  32. 32. CH P IP
  33. 33. Third ventriculostomy
  34. 34. Third ventriculostomy
  35. 35. PNSAH • Peri-mesencephalic Non-aneurysmal Sub-Arachnoid Hemorrhage. • Pre-truncal Non-aneurysmal Sub-Arachnoid Hemorrhage. • Brain stem = truncus cerebri. • Low pressure bleeding. • Source: perimesencephalic vein.
  36. 36. Lamina terminalis cistern
  37. 37. Pericallosal cistern
  38. 38. Pericallosal artery aneurysm
  39. 39. Subarachnoid hemorrhage
  40. 40. Quadrigeminal cistern vein of Galen cistern
  41. 41. Vein of Galen aneurysm
  42. 42. Precentral V Precentral VPrecentral V
  43. 43. Precentral V
  44. 44. Quadrigeminal cistern epidermoid cyst
  45. 45. Superior cerebellar cistern
  46. 46. Vellum interpositum cistern (double layered tela choroidae)
  47. 47. Embryologic Basis for the Development and Anatomy of the Cavum Veli Interpositi
  48. 48. Vellum interpositum cistern
  49. 49. Cavum vili interpositi
  50. 50. Cavum villi interpositi Cavum septum pellucidum & cavum vergae
  51. 51. Cisterna magna Cerebellomedullary cistern
  52. 52. Mega cisterna magna Mega cisterna magna
  53. 53. Vallecula cerebelli Vallecula
  54. 54. Dandy walker variant
  55. 55. CP angle cisterns
  56. 56. CP angle cistern AICA
  57. 57. Superior CP angle cistern AICA AICA AICA AICA
  58. 58. Inferior CP angle cistern Cn 9/10 Cn 10 Cn 9
  59. 59. Inferior CP angle arachnoid cyst
  60. 60. Crural cisterns Between the Crus cerebri (cerebral peduncles Uncus of temporal lobe Medially Laterally
  61. 61. AchA AchAAchA SCA PCA PCA
  62. 62. Carotid cisterns
  63. 63. Sylvian cisterns
  64. 64. Ambient cisterns
  65. 65. Trochlear N.
  66. 66. PCA
  67. 67. Basal vein of Rosenthal
  68. 68. Basal vein of Rosenthal
  69. 69. Basal vein of Rosenthal
  70. 70. Cn 4 epidermoid
  71. 71. Trochlear N. schwannoma
  72. 72. Retro-thalamic cisterns wings of ambient cisterns
  73. 73. Vellum interpositum Retro-thalamic CisternRetro-thalamic Cistern Sup.cerebellar Cistern
  74. 74. Overview of CSF spaces
  75. 75. Overview of CSF spaces Normal: All CSF spaces are visible neither effaced or dilated.
  76. 76. Overview of CSF spaces Normal: All CSF spaces are visible neither effaced or dilated. Atrophy: All CSF spaces are dilated. Hydrocephalus: Ventricles dilated. Subarachnoid spaces effaced. Edema: All CSF spaces are effaced.
  77. 77. Overview of CSF spaces Normal: All CSF spaces are visible neither effaced or dilated. Atrophy: All CSF spaces are dilated.
  78. 78. Overview of CSF spaces Normal: All CSF spaces are visible neither effaced or dilated. Atrophy: All CSF spaces are dilated. Hydrocephalus: Ventricles dilated. Subarachnoid spaces effaced.
  79. 79. Overview of CSF spaces Normal: All CSF spaces are visible neither effaced or dilated. Atrophy: All CSF spaces are dilated. Hydrocephalus: Ventricles dilated. Subarachnoid spaces effaced. Edema: All CSF spaces are effaced.
  80. 80. Benign external hydrocephalus
  81. 81. 3 years10 months Benign external hydrocephalus
  82. 82. Benign external hydrocephalus benign enlargement of subarachnoid spaces in infancy Etiology: • Immature arachnoid granulations. C.P: • Macrocephaly. • Normal developmental milestones.
  83. 83. 1. Widening of the bifrontal subarachnoid space and anterior interhemispheric fissure (>5mm). 2. Usually normal subaracnoid space posteriorly. 3. No flattening of adjacent gyri. 4. The anterior fontanelle is frequently enlarged. 5. The ventricular system is within normal limits or slightly dilated. 6. There are no pressure effects on the surrounding brain tissue or cerebral atrophy. 7. No blood products on MRI study. 8. another key distinction between benign enlargement of the subarachnoid spaces and a subdural fluid collection is that in the former the cortical veins will be adjacent to the inner table of the calvarium on MR and ultrasound; whereas in the latter the veins are displaced away from the inner table, as the arachnoid membrane and subarachnoid space are displaced.
  84. 84. Benign external hydrocephalus
  85. 85. Benign external hydrocephalus
  86. 86. External hydrocephalus vs subdural hematoma
  87. 87. Hydrocephalus versus atrophy Features that favor hydrocephalus • Dilatation of the temporal horns • Peri-ventricular interstitial oedema . • intra-ventricular flow void from CSF movement on MR • Widening of the third ventricular recesses : mid sagittal plane • Upward bowing of the corpus callosum : mid sagittal plane • Decreased mammillo-pontine distance : mid sagittal plane
  88. 88. Mid-sagittal findings of hydrocephalus • Widening of the third ventricular recesses. • Upward bowing of the corpus callosum. • Decreased mammillo- pontine distance .
  89. 89. Periventricular leukomalacia

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