The document summarizes the circulation of cerebrospinal fluid (CSF) and veins of the head. It also discusses craniotomy procedures. Specifically: 1) CSF flows from the ventricles into the subarachnoid space through openings in the brain, circulating around the brain and spinal cord. 2) Veins of the head are divided into external and internal groups, with internal veins including diploic veins connecting to dura mater sinuses. 3) Craniotomy procedures include osteoplastic craniotomy for accessing the skull in surgery, and decompression craniotomy to relieve pressure by creating a skull defect over a brain bulge.

1. Lecturer: Nuruev Mirlan

13. Circulation of the Cerebrospinal Fluid
• The fluid flows through the interventricular foramen (of
Monro) into the third ventricle, is augmented by fluid
formed by the choroid plexus of this ventricle, and passes
through the cerebral aqueduct (of Sylvius) to the fourth
ventricle, which also possesses a choroid plexus. The CSF
from all theses sources , as well as any formed in the
central canal of the spinal cord, escapes from the fourth
ventricle into the subarachnoid space through the median
aperture (of Magendie) and lateral aperture (of Luschka).
• The CSF then circulates through the freely communicating
subaracchnoid cisterns at the base of the brain. From the
cisterns, most of the CSF is directed upward over the
cerebral hemispheres and smaller amounts pass
downward around the spinal cord.

15. Veins of the head
(1) The veins of the exterior of the
head.
(Frontal. Superficial Temporal. Supraorbital. Internal
Maxillary. Angular. Posterior Facial. Anterior Facial.
Posterior Auricular. Occipital)
(2) The internal veins of the head.
Diploic veins,
Emissary veins
Veins of the brain,
Venous sinuses of the dura mater.

16. Diploic veins
They communicate with
the meningeal veins and
the sinuses of the dura
mater, and with the veins
of the pericranium.
• Frontal
• Anterior temporal
• Posterior temporal
• Occipital

17. Emissary veins
Venous connection between a venous
sinus, diploic veins and superficial
cranial veins.
• Parietal emissary v.
• Mastoid emissary v.
• Condylar emissary v.
• Occipital emissary v.

18. Venous sinuses of the dura mater.
• Transverse sinus
• Occipital sinus
• Sigmoid sinus
• Superior sagittal sinus
• Inferior sagittal sinus
• Staight sinus (rectus)
• Inferior petrosal sinus
• Superior petrosal sinus
• Cavernous sinus
• Sphenoparietal sinus

21. Craniotomy
There are two types of craniotomy:
osteoplastic, which is the operative access
to the cranial cavity and is performed in two
ways (one-patchwork - Wagner-Wolf and two-
patchwork - Olivecron) and
decompression (decompressive, resection),
which is a palliative operation, including
prompt access and operational reception
Indications: abscess, hematoma,
brain tumor.

22. Craniotomy
Decompression trepanation of the skull
Decompression craniotomy is a
palliative operation: it is performed
with an increase in intracranial
pressure in cases of inoperable brain
tumors, with progressive edema that
develops as a result of injury.

23. Craniotomy
The purpose of the operation is to create
a defect in the bones of the skull and
dura mater in a specific area of the arch.
In the bed formed in this way, a brain
bulge occurs, which reduces the increase
in intracranial pressure. Trepanation
window impose over the lesion. Currently,
the operation is performed mainly in the
temporal region by Cushing.

24. Craniotomy

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