III. Learning unit: Purulent meningitis           

Objectives and competencies

This syllabus covers clinico-pathological relevancies of purulent meningitis in multidisciplinary approach. The anatomical chapter describes innervation, blood supply and embryology of the meninges including the dura the arachnoid and pia mater. Students may learn features and forms and etiology of purulent meningitis. The radiological chapter covers general features and characteristics of purulent meningitis on CT and MR imaging. Students may study distinctive characteristics of granulomatous meningitis with special emphasis on its complications. The clinical chapter introduces epidemiology, clinical course, symptomatology, histopathology, non-imaging tools of diagnosis, differential diagnosis and treatment modalities in multimedia enhanced environment with illustrations photos and tables.

III./1. fejezet: Coverings of the Brain (Meninges)

Gabor Baksa

III./1.1.: Introduction

The meninges consist of layers of connective tissue which enclose the brain and spinal cord, they form a barrier between the central nervous system and its surroundings and also form functionally relevant spaces within the skull and the spinal canal. The present chapter only covers the anatomy of the cerebral meninges. At the end of this chapter a summary of the meningeal ontogenesis is found.

According to their consistency outer tough (pachy-) and inner soft (lepto-) meninges are distinguished. The pachymeninges are represented by the dura mater, while the leptomeninges are consist of the the pia mater and the arachnoid membrane. Under physiological circumstances (subarachnoid) space exits only between the arachnoid and the pia mater, but under pathological conditions space may evolve under (subdural) and above (epidural) the dura as well as under the pia mater (subpial), where otherwise the meninges as well as the meninges and the nervous tissue are adhered closely but separably.

The chapter structure

• III./1.1.: Introduction

• III./1.2.: Dura mater

  • III./1.2.1.: Layers of the dura mater

  • III./1.2.2.: Surroundings of the dura mater

  • III./1.2.3.: Further processes of the dura mater

  • III./1.2.3.1.: Dural poruses

  • III./1.2.3.2.: Dural venous sinuses

  • III./1.2.3.3.: Bridge veins

• III./1.3.: Arachnoid

• III./1.4.: Pia mater

• III./1.5.: Blood supply of the meninges

• III./1.6.: The innervation of the meninges

• III./1.7.: Development of the meninges (ontogenezis)

References

Boenig: Leitfaden der Entwicklungsgeschichte des Menschen. Georg Thieme Verlag 1938.

Clara: Das Nervensystem des Menschen. Johann Ambrosius Barth Verlag 1959.

Bähr, Frotscher: Duus’ Neurologisch-topische Diagnostik. Georg Thieme Verlag 2003.

Hajdu: Vezérfonal a neuroanatómiához. Semmelweis Kiadó 2004.

Rauber-Kopsch: Lehrbuch der Anatomie – Abteilung V. Georg Thieme Verlag 1920.

Szentágothai – Réthelyi: Funkcionális anatómia 3. Medicina Kiadó – Semmelweis Kiadó 1996.

Törő: Az ember fejlődése. Debreceni M. Kir. Tisza István Tudományegyetemi Nyomda 1942.

Yasargil: Microneurosurgery. Georg Thieme Verlag 1984.