Central nervous system disorders

III./1.6.: The innervation of the meninges

The dura is mostly innervated by the trigeminal nerve. In the anterior cranial fossa the innervation is via the anterior meningeal ramus of the ophthalmic nerve, through its branches the nasociliary and the anterior ethmoidal nerve. Backwards and in the middle cranial fossa the medial meningeal ramus of the maxillary nerve, the meningeal branch of mandibular nerve) and the tentorial branch of the ophthalmic nerve innervates the dura. The latter supplies the lateral wall of the cavernous sinus and the tentorium. The posterior meningeal rami arise from the superior ganglion of vagus nerve and innervate the dura mater of the posterior cranial fossa. The sympathetic nerves of the dura derive from the superior cervical ganglion.

The leptomeninges have no pain sensitivity, however due to their symphatetic innervation they are sensitive to tension and chemical stimuli. It is presumed that sympathetic fibers found in certain parts of the arachnoid are responsible for the spasm of the arteries (vasospasm) after subarachnoid hemorrhage.