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Type:
Educational Exhibit
Keywords:
Anatomy, CNS, CT, MR, eLearning, Normal variants, Cerebrospinal fluid
Authors:
D. Eiroa1, P. N. Nuñez Vila2, V. Vázquez Sánchez2, E. Alventosa Fernández2, C. González2; 1Santa Cruz de Tenerife/ES, 2Tenerife/ES
DOI:
10.1594/ecr2016/C-0264
Findings and procedure details
There are a few proposed classification systems for the subarachnoid cisterns.
One of the most used is the Liliequist classification of CSF cisterns,
that separates them in ventral,
dorsal and communicating cisterns.
A description of the classification is provided in Table 1 .
Below,
the reader can find a detailed description of each of the cisterns referred in Table 1:
VENTRAL CISTERNS
- Chiasmatic or supra-sellar cistern: this cistern lies superiorly to the sellar diaphragm (part of the subarachnoid space goes through the infundibular orifice and forms a small cavity above the pituitary gland),
and close to the optic nerves,
chiasma and tracts as well as the Willis circle and the hypothalamus.
(Fig. 2 and Fig. 4).
The parasellar cisterns constitute the lateral continuations of the suprasellar cistern and contain a segment of the oculomotor nerve as well as the posterior communicating and anterior choroidal arteries and the basal vein.
- Sylvian or lateral cisterns: they communicate medially with the supra and para-sellar cisterns and laterally with the subarachnoid space of the lateral (Sylvian) fissure.
It contains the M1 segment of the middle cerebral artery,
the origin of the lenticulostriate branches and the first portion of the basal vein. (Fig. 5)
- Medullary cistern: the subarachnoid space surrounding the medulla oblongata.
It has a posterior communication with the cisterna magna. (Fig. 2)
- Pontine cistern: It encases the pons and shows a central portion and two lateral recesses located between the pons and the cerebellum.
This cistern is limited superiorly by the cerebellar tentorium.
Its content comprise,
in a descending fashion: the 5th cranial nerve,
the superior cerebellar artery,
the 4th 8th and 7th cranial nerves,
the loop of the anterior-inferior cerebellar artery,
the 9th,
10th and 11th cranial nerves in close relationship with the posterior-inferior cerebellar artery,
the 12th cranial nerve and the basilar artery. (Fig. 2)
- Crural cisterns: are the spaces located between the cerebral peduncles (medially) and the uncus (laterally).
(Fig. 4)
- Inter-peduncullar cistern: limited anteriorly by the sella turcica,
the pituitary stalk and the optic chiasma.
The membrane of Liliequist incompletely separates it of the chiasmatic cistern.
It contains the bifurcation of the basilar artery and the aparent origin of the 3rd cranial nerve. (Fig. 4)
DORSAL CISTERNS
- Ambient and quadrigeminal cisterns or cistern of the great cerebral vein: it is located between the splenium of the corpus callosum and the cerebellum and contains the great cerebral vein,
thus the name,
the aparent origin of the 4th cranial nerve,
and the pineal gland. (Fig. 4 and Fig. 7)
- Peri-callosal cistern: It is a narrow space right above the corpus callosum which encases the pericallosal artery.
(Fig. 2)
- Retro-thalamic cistern: also considered the "wings" of the ambient cistern,
are the lateral extensions of the ambient cisterns located posterior to the pulvinar nuclei. (Fig. 6)
- Supra-cerebellar cistern: It is the subarachnoid space between the tentorium of the cerebellum and the superior aspect of the cerebellar vermis and encloses the superior cerebellar artery and superior vermian veins.
(Fig. 2 and Fig. 6)
COMMUNICATING CISTERNS
- Cistern of the lamina terminalis: it extends above the anterior aspect of the third ventricle.
It contains the first segment of the anterior cerebral arteries and its branches.
This cistern acts as a communcation among the peri-callosal,
and inter-peduncular cisterns.(Fig. 2 and Fig. 3)
- Cisterna Magna or cerebello-medullary cistern: It is the biggest of the subarachnoid cysterns.
Located under the cerebellum and behind the medulla oblongata.
It communicates with the fourth ventricle (via the median aperture or foramen of Magendie),
the medullary subarachnoid space,
and the peri-cerebellar subarachnoid space.
(Fig. 2 and Fig. 8)