# Meninges > Mediated Wiki article. Canonical URL: https://mediated.wiki/source/Meninges > Markdown URL: https://mediated.wiki/source/Meninges.md > Source: https://en.wikipedia.org/wiki/Meninges > Source revision: 1339391760 > License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/) {{Short description|Three membranes protecting the brain}} {{redirect|Meninx|the Tunisian archaeological site|Meninx (town)}} {{Infobox anatomy | Name = Meninges | Latin = meninges | Greek = | Image2 = Meninges-en.svg | Caption2 = The meninges: dura mater, arachnoid mater and pia mater | Width = | Image = 3D Medical Illustration Meninges Details.jpg | Caption = Image depicting meninges around the brain | Precursor = | System = | Artery = [Middle meningeal artery](/source/Middle_meningeal_artery), [meningeal branches of the ascending pharyngeal artery](/source/meningeal_branches_of_the_ascending_pharyngeal_artery), [accessory meningeal artery](/source/accessory_meningeal_artery), branch of [anterior ethmoidal artery](/source/anterior_ethmoidal_artery), [meningeal branches of vertebral artery](/source/meningeal_branches_of_vertebral_artery) | Vein = | Nerve = [Middle meningeal nerve](/source/Middle_meningeal_nerve), [nervus spinosus](/source/nervus_spinosus) | Lymph = }} In [anatomy](/source/anatomy), the '''meninges''' ({{IPAc-en|m|ə|ˈ|n|ɪ|n|dʒ|iː|z}};{{cite web |title=meninges |url=https://oxfordlearnersdictionaries.com/definition/english/meninges |website=Oxford Learner's Dictionaries}}{{cite Merriam-Webster|meninges |access-date=2012-07-28}} {{singular}} '''meninx''' {{IPAc-en|ˈ|m|iː|n|ɪ|ŋ|k|s|,_|ˈ|m|ɛ|n|ɪ|ŋ|k|s}};{{cite Merriam-Webster|meninx |access-date=2012-07-28}} {{etymology|grc|''{{wikt-lang|grc|μῆνινξ}}'' ({{grc-transl|μῆνιγξ}})|membrane}}){{LSJ|mh{{=}}nigc|μῆνιγξ|ref}} are protective [membrane](/source/membrane)s that cover the [brain](/source/brain) and [spinal cord](/source/spinal_cord). In [mammal](/source/mammal)s, three meninges have been clearly identified: the [dura mater](/source/dura_mater), the [arachnoid mater](/source/arachnoid_mater), and the [pia mater](/source/pia_mater). Each layer has its own molecularly distinct type of [fibroblasts](/source/fibroblasts).{{cite journal |last1=Betsholtz |first1=C |last2=Engelhardt |first2=B |last3=Koh |first3=GY |last4=McDonald |first4=DM |last5=Proulx |first5=ST |last6=Siegenthaler |first6=J |title=Advances and controversies in meningeal biology. |journal=Nature Neuroscience |date=November 2024 |volume=27 |issue=11 |pages=2056–2072 |doi=10.1038/s41593-024-01701-8 |pmid=39333784 |pmc=11862877 |url=https://escholarship.org/uc/item/7sx757mx }} The meninges act as a physical and immunological protective barrier for the brain and spinal cord, shielding the [central nervous system](/source/central_nervous_system) (CNS) from injury. They anchor and support the tissues of the CNS, and provide containment for cerebrospinal fluid (CSF) and the arteries and veins that supply blood to the brain and spinal cord.{{cite web |last1=Castillero Mimenza |first1=Oscar |date=January 2017 |title=Meninges: anatomía, partes y funciones en el cerebro |url=https://psicologiaymente.com/neurociencias/meninges}} The dura mater surrounds the arachnoid mater and supports the [dural sinuses](/source/dural_sinuses), which carry blood from the brain to the heart. The area between the arachnoid and pia mater is known as the subarachnoid space. It contains [cerebrospinal fluid](/source/cerebrospinal_fluid). The arachnoid and pia maters produce [prostaglandin D2 synthase](/source/prostaglandin_D2_synthase), a major cerebrospinal fluid protein. The arachnoid mater provides a restrictive permeability barrier between the cerebrospinal fluid in the subarachnoid space and the circulation of blood in the dura. The pia mater is a thin sheet of connective tissue that interfaces with the [glial limitans superficialis](/source/Glia_limitans). ==Structures== ===Dura mater=== {{Main|Dura mater}} The dura mater ({{langx|la|tough mother}}),{{cite dictionary|url=https://www.merriam-webster.com/dictionary/dura+mater|title=Definition of dura mater|dictionary=[Merriam-Webster](/source/Merriam-Webster) Online Dictionary|access-date=22 June 2022}}{{Efn|Also rarely called ''meninx fibrosa'' or ''pachymeninx''}} is a durable, thick fibrous membrane that attaches to the inside of the [skull](/source/skull) and covers the brain and vertebrae. Its dense fibrous tissue is formed from an interlay of [collagen fibers](/source/Collagen), [elastin](/source/elastin), and [fibroblast](/source/fibroblast)s in an unformed extracellular matrix.{{Cite journal |last1=Niestrawska |first1=JA |last2=Rodewald |first2=M |last3=Schultz |first3=C |last4=Quansah |first4=E |last5=Meyer-Zedler |first5=T |last6=Schmitt |first6=M |last7=Popp |first7=J |last8=Tomasec |first8=I |last9=Ondruschka |first9=B |last10=Hammer |first10=N |date=2023-10-15 |title=Morpho-mechanical mapping of human dura mater microstructure |url=https://www.sciencedirect.com/science/article/pii/S1742706123004865 |journal=Acta Biomaterialia |volume=170 |pages=86–96 |doi=10.1016/j.actbio.2023.08.024 |pmid=37598794 |issn=1742-7061}} The dura mater is itself a two layered membrane: an outer [endosteal](/source/endosteal) (periosteal) layer lies closest to the skull, and an inner (meningeal or dura mater proper) layer lies closer to the brain.{{cite journal |last1=Suh |first1=DC |title=Where Did the Dura Mater Come from? |journal=Neurointervention |date=March 2020 |volume=15 |issue=1 |pages=2–3 |doi=10.5469/neuroint.2020.00045 |pmid=32093449 |pmc=7105093 }} These layers separate to surround the [Dural venous sinuses](/source/Dural_venous_sinuses). Sensory and autonomic nerves innervate the dura, and are dense near its blood vessels. The dura's inner surface is covered by flattened [fibrocyte](/source/fibrocyte)s which are adhered to by the outer cells of the arachnoid mater.{{Cite book |last1=Figueiredo |first1=Marxa L. |url=https://books.google.com/books?id=7gVVEQAAQBAJ&dq=inner+surface+of+the+dura+mater+inner+surface+is+covered+by+flattened+cells&pg=PA99 |title=Dellmann's Textbook of Veterinary Histology |last2=Turek |first2=John J. |date=2025-04-09 |publisher=John Wiley & Sons |isbn=978-1-394-19670-8 |language=en}} The dura mater surrounds the arachnoid mater and supports the [dural sinuses](/source/dural_sinuses) which carry blood from the brain to the heart.{{cite journal |last1=Dasgupta |first1=K |last2=Jeong |first2=J |title=Developmental biology of the meninges. |journal=Genesis |date=2019 |volume=57 |issue=5 |article-number=e23288 |doi=10.1002/dvg.23288 |pmid=30801905 |pmc=6520190 }} The dura mater folds inwards upon itself to form four areas of infolding called dural reflections:{{Cite book |last1=Agur |first1=Anne M. R. |url=https://books.google.com/books?id=HJWkEAAAQBAJ&dq=dura+has+four+areas+of+infolding:+Falx++cerebri+-StatPearls&pg=PT1071 |title=Moore's Essential Clinical Anatomy |last2=Dalley |first2=Arthur F. |date=2022-12-29 |publisher=Lippincott Williams & Wilkins |isbn=978-1-9751-7425-5 |language=en}}{{Cite book |last=Andreatta |first=Richard D. |url=https://books.google.com/books?id=XfqUEAAAQBAJ&dq=arachnoid+loosley+fitting+sac&pg=PA259 |title=Neuroscience Fundamentals for Communication Sciences and Disorders, Second Edition |date=2022-10-13 |publisher=Plural Publishing |isbn=978-1-63550-360-9 |language=en}} * [Falx cerebri](/source/Falx_cerebri): This sickle-shaped fold is the largest of the dural reflections. It separates the two [cerebral hemisphere](/source/cerebral_hemisphere)s, and is anchored to the [crista galli](/source/crista_galli) of the [ethmoid bone](/source/ethmoid_bone) and the [internal occipital protuberance](/source/internal_occipital_protuberance). * [Tentorium cerebelli](/source/Tentorium_cerebelli). The second largest fold is also crescent-shaped. It separates the [occipital lobe](/source/occipital_lobe)s of the [cerebrum](/source/cerebrum) from the [cerebellum](/source/cerebellum). The falx cerebri attaches to it to form the roof of the [posterior cranial fossa](/source/posterior_cranial_fossa), which gives it a tentlike appearance.{{cite journal |last1=Rai |first1=R |last2=Iwanaga |first2=J |last3=Shokouhi |first3=G |last4=Oskouian |first4=RJ |last5=Tubbs |first5=RS |title=The Tentorium Cerebelli: A Comprehensive Review Including Its Anatomy, Embryology, and Surgical Techniques. |journal=Cureus |date=31 July 2018 |volume=10 |issue=7 |article-number=e3079 |doi=10.7759/cureus.3079 |doi-access=free |pmid=30305987 |pmc=6168052 }} * [Falx cerebelli](/source/Falx_cerebelli): This vertical infolding is located inferior to the tentorium cerebelli. It partially separates the [cerebellar hemisphere](/source/cerebellar_hemisphere)s. * [Diaphragma sellae](/source/Diaphragma_sellae): The smallest of the infoldings, it forms a roof over the [sella turcica](/source/sella_turcica) and seals the [pituitary gland](/source/pituitary_gland) from the subarachnoid space.{{cite journal |last1=Rasmussen |first1=MK |last2=Mestre |first2=H |last3=Nedergaard |first3=M |title=Fluid transport in the brain. |journal=Physiological Reviews |date=1 April 2022 |volume=102 |issue=2 |pages=1025–1151 |doi=10.1152/physrev.00031.2020 |pmid=33949874 |pmc=8897154 }} thumb|Diagram of brain layers ===Arachnoid mater=== {{Main|Arachnoid mater}} thumb|upright=1.6|Diagram of section of top of brain showing the meninges and subarachnoid space The [arachnoid mater](/source/arachnoid_mater), or arachnoid membrane, is the middle element of the meninges. Thin and transparent, its name reflects its resemblance to a [spider web](/source/spider_web). Its fibrous tissue cushions the [central nervous system](/source/central_nervous_system). Like the pia mater, it has an outer layer of tightly packed flat cells, forming the arachnoid barrier.{{cite journal |last1=Abbott |first1=NJ |last2=Patabendige |first2=AA |last3=Dolman |first3=DE |last4=Yusof |first4=SR |last5=Begley |first5=DJ |title=Structure and function of the blood-brain barrier. |journal=Neurobiology of Disease |date=January 2010 |volume=37 |issue=1 |pages=13–25 |doi=10.1016/j.nbd.2009.07.030 |pmid=19664713|s2cid=14753395 }} The arachnoid is loosely fitting and does not closely follow the ridges and grooves on the surface of the brain. A large number of fine filaments called [arachnoid trabeculae](/source/arachnoid_trabeculae) pass from the arachnoid through the subarachnoid space to blend with the tissue of the pia mater.{{cite book |last1=Schröder |first1=Hannsjörg |last2=Vos |first2=Rob A. I. de |last3=Huggenberger |first3=Stefan |last4=Müller-Thomsen |first4=Lennart |last5=Rozemuller |first5=Annemieke |last6=Hedayat |first6=Farman |last7=Moser |first7=Natasha |title=The Human Brainstem: Anatomy and Pathology |date=8 August 2023 |publisher=Springer Nature |isbn=978-3-030-89980-6 |page=71 |url=https://books.google.com/books?id=fBfQEAAAQBAJ&dq=arachnoid+trabeculae+pass+from+the+arachnoid+through+the+subarachnoid+space+to+blend+with+the+tissue+of+the+pia+mater.&pg=PA71 |language=en}} The arachnoid barrier creates a restrictive permeability barrier between the cerebrospinal fluid in the subarachnoid space and the blood circulation in the dura. The arachnoid barrier layer is characterized by a distinct continuous basal lamina on its inner surface toward the innermost collagenous portion of the arachnoid reticular layer.{{cite journal |last1=Izadi |first1=N |last2=Solár |first2=P |last3=Hašanová |first3=K |last4=Zamani |first4=A |last5=Akbar |first5=MS |last6=Mrázová |first6=K |last7=Bartošík |first7=M |last8=Kazda |first8=T |last9=Hrstka |first9=R |last10=Joukal |first10=M |title=Breaking boundaries: role of the brain barriers in metastatic process. |journal=Fluids and Barriers of the CNS |date=8 January 2025 |volume=22 |issue=1 |page=3 |doi=10.1186/s12987-025-00618-z |doi-access=free |pmid=39780275 |pmc=11708195 |issn=2045-8118}} ===Pia mater=== {{Main|Pia mater}} The pia mater ({{langx|la|tender mother|links=no}}){{cite dictionary|url=https://www.merriam-webster.com/dictionary/pia+mater|title=Definition of pia mater|dictionary=[Merriam-Webster](/source/Merriam-Webster) Online Dictionary|access-date=27 November 2015}} is a very delicate membrane. It is the meningeal envelope that firmly adheres to the surfaces of the brain and spinal cord, following all of the brain's contours ([gyri](/source/gyrus) and [sulci](/source/sulcus_(neuroanatomy))).{{Cite book |last1=Barichello |first1=Tatiana |url=https://books.google.com/books?id=PE7VEAAAQBAJ&dq=gyri+pia+mater&pg=PA13 |title=Neurobiology of Infectious Diseases |last2=Dal-Pizzol |first2=Felipe |last3=Hasbun |first3=Rodrigo |date=2024-11-30 |publisher=Elsevier |isbn=978-0-443-19131-2 |page=13 |language=en}} It is a very thin sheet of connective tissue that interfaces with the glial limitans superficialis but lacks capillaries itself. === Subarachnoidal lymphatic-like membrane === {{Excerpt|subarachnoidal lymphatic-like membrane}} ===Leptomeninges=== The [arachnoid](/source/arachnoid_(brain)) and [pia mater](/source/pia_mater) are sometimes together called the ''leptomeninges'',{{cite web|title=leptomeninges |url=https://en.oxforddictionaries.com/definition/leptomeninges|archive-url=https://web.archive.org/web/20161104012057/https://en.oxforddictionaries.com/definition/leptomeninges|archive-date=November 4, 2016|website=Oxford Dictionaries {{!}} English}} literally "thin meninges" ({{langx|el|λεπτός}} "leptos"—"thin"). Acute [meningococcal meningitis](/source/meningococcal_meningitis) can lead to an [exudate](/source/exudate) within the leptomeninges along the surface of the brain.{{Cite book |last=Kumar |first=Vinay |year=2015 |title=Robbins and Cotran Pathologic Mechanisms of Disease |location=Philadelphia |publisher=Elsevier Saunders |edition=9th |page=1273 |oclc=892583347 |quote=In acute meningitis, an exudate is evident within the leptomeninges over the surface of the brain (Fig. 28-21).}} Because the arachnoid is connected to the pia by cobweb-like strands, it is structurally continuous with the pia, hence the name pia-arachnoid or leptomeninges. They are responsible for the production of beta-trace protein ([prostaglandin D2 synthase](/source/prostaglandin_D2_synthase)), a major cerebrospinal fluid protein.{{cite journal |last1=Yamashima |first1=Tetsumori |last2=Sakuda |first2=Kazushige |last3=Tohma |first3=Yasuo |last4=Yamashita |first4=Junkoh |last5=Oda |first5=Hiroshi |last6=Irikura |first6=Daisuke |last7=Eguchi |first7=Naomi |last8=Beuckmann |first8=Carsten T. |last9=Kanaoka |first9=Yoshihide |last10=Urade |first10=Yoshihiro |last11=Hayaishi |first11=Osamu |title=Prostaglandin D Synthase (β-Trace) in Human Arachnoid and Meningioma Cells: Roles as a Cell Marker or in Cerebrospinal Fluid Absorption, Tumorigenesis, and Calcification Process |url= |journal=Journal of Neuroscience |pages=2376–2382 |language=en |date=1 April 1997 |volume=17 |issue=7 |doi=10.1523/JNEUROSCI.17-07-02376.1997|pmid=9065498 |pmc=6573504 |s2cid=15404074 }} ===Subarachnoid space=== thumb|Diagram of section of spinal cord showing the meninges and spaces. Subarachnoid space coloured blue The '''subarachnoid space''' is the space that normally exists between the [arachnoid](/source/arachnoid_(brain)) and the [pia mater](/source/pia_mater). It is filled with [cerebrospinal fluid](/source/cerebrospinal_fluid) and continues down the [spinal cord](/source/spinal_cord). Spaces are formed from openings at different points along the subarachnoid space; these are the [subarachnoid cisterns](/source/subarachnoid_cisterns), which are filled with cerebrospinal fluid.{{cite journal |last1=Hladky |first1=SB |last2=Barrand |first2=MA |title=Regulation of brain fluid volumes and pressures: basic principles, intracranial hypertension, ventriculomegaly and hydrocephalus. |journal=Fluids and Barriers of the CNS |date=17 July 2024 |volume=21 |issue=1 |page=57 |doi=10.1186/s12987-024-00532-w |doi-access=free |pmid=39020364 |pmc=11253534 }} The [dura mater](/source/dura_mater) is attached to the [skull](/source/Human_skull), whereas in the spinal cord, the dura mater is separated from the [vertebra](/source/vertebra)e by a space called the [epidural space](/source/epidural_space), which contains fat and blood vessels. The arachnoid is attached to the dura mater, while the pia mater is attached to the central nervous system tissue. If the dura mater and the arachnoid become separated due to injury or illness, the space between them is known as the '''[subdural space](/source/subdural_space)'''.{{cite book |last1=Carstens |first1=Michael H. |title=The Embryologic Basis of Craniofacial Structure: Developmental Anatomy, Evolutionary Design, and Clinical Applications |date=27 September 2023 |publisher=Springer Nature |isbn=978-3-031-15636-6 |page=1040 |url=https://books.google.com/books?id=w_XZEAAAQBAJ&dq=meninges+Giuseppe+Sterzi&pg=PA1040 |language=en}}{{cite journal |last1=Macpherson |first1=D |last2=Quondamatteo |first2=F |last3=Broom |first3=M |title=Update on applied epidural anatomy. |journal=BJA Education |date=May 2022 |volume=22 |issue=5 |pages=182–189 |doi=10.1016/j.bjae.2021.12.006 |pmid=35496647 |pmc=9039569 }} There is another potential space, the '''subpial space''', between the pia mater and the [glia limitans](/source/glia_limitans).{{cite journal |last1=Server |first1=A |last2=Latysheva |first2=A |last3=Nedregaard |first3=B |last4=Rønnestad |first4=AE |last5=Marthinsen |first5=PB |title=Neonatal subpial hemorrhage: clinical presentation, neuroimaging findings and outcome. |journal=Neuroradiology |date=April 2025 |volume=67 |issue=4 |pages=1071–1080 |doi=10.1007/s00234-025-03589-y |pmid=40095005 |pmc=12041188 }} ==Clinical significance== === Intracranial hemorrhage === Three types of [intracranial hemorrhage](/source/intracranial_hemorrhage) can involve the meninges: epidural, subdural, and subarachnoid. * A [subarachnoid hemorrhage](/source/subarachnoid_hemorrhage) is acute bleeding under the arachnoid; it may occur spontaneously or as a result of trauma.{{cite journal |vauthors=van Gijn J, Kerr RS, Rinkel GJ |title=Subarachnoid haemorrhage |journal=Lancet |volume=369 |issue=9558 |pages=306–18 |year=2007 |pmid=17258671 |doi=10.1016/S0140-6736(07)60153-6|s2cid=29126514 }}{{cite book |last1=Parizel |first1=Paul M. |last2=Philips |first2=C. Douglas |title=Diseases of the Brain, Head and Neck, Spine 2020–2023 |date=2020 |publisher=Springer International Publishing |isbn=978-3-030-38489-0 |pages=77–92 |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK554351/ |language=en |chapter=Traumatic Neuroemergency: Imaging Patients with Traumatic Brain Injury—An Introduction |doi=10.1007/978-3-030-38490-6_7 |pmid=32119255 }} * A [subdural hematoma](/source/subdural_hematoma) (SDH) is an extracerebral collection of blood located in the potential space that can separate [arachnoid](/source/arachnoid_(brain)) from the dura mater. The origin is usually venous, caused by injury to the [bridging vein](/source/bridging_vein)s that connect the dura mater and the [arachnoid](/source/arachnoid_(brain)). Once these are torn, blood leaks into this area. SDHs occur in about 30% cases of severe head trauma. * An [epidural hematoma](/source/epidural_hematoma) (EDH) is a collection of blood between the [skull](/source/skull) and the dura mater, underlying a bare bone surface. It is often associated with skull fracture. EDH may be arterial (caused by injury of a meningeal artery) or venous (related to damage to of a dural venous sinus or bleeding from diploic veins). ====Meningioma==== [Meningioma](/source/Meningioma)s are the most common type of primary [brain tumors](/source/brain_tumors) to occur in adults. They are thought to arise from meningothelial arachnoid cells in the meninges. Most commonly they attach firmly to the inner surface of the dura and are well-circumscribed; but some [tumors](/source/tumors) may show brain invasion.{{cite journal |last1=Szulzewsky |first1=F |last2=Thirimanne |first2=HN |last3=Holland |first3=EC |title=Meningioma: current updates on genetics, classification, and mouse modeling. |journal=Upsala Journal of Medical Sciences |date=2024 |volume=129 |article-number=e10579 |doi=10.48101/ujms.v129.10579 |pmid=38571886 |pmc=10989216 }} More rarely, [leptomeningeal cancer](/source/leptomeningeal_cancer)s may [metastasize](/source/metastasis) from tumors elsewhere in the body to the cerebrospinal fluid and leptomeninges.{{cite journal |last1=Nguyen |first1=A |last2=Nguyen |first2=A |last3=Dada |first3=OT |last4=Desai |first4=PD |last5=Ricci |first5=JC |last6=Godbole |first6=NB |last7=Pierre |first7=K |last8=Lucke-Wold |first8=B |title=Leptomeningeal Metastasis: A Review of the Pathophysiology, Diagnostic Methodology, and Therapeutic Landscape. |journal=Current Oncology |date=19 June 2023 |volume=30 |issue=6 |pages=5906–5931 |doi=10.3390/curroncol30060442 |doi-access=free |pmid=37366925 |pmc=10297027 }} ====Meningitis==== Other medical conditions that affect the meninges include [meningitis](/source/meningitis), which usually arises from a [viral](/source/virus), [bacterial](/source/bacterial), or [fungal](/source/fungal) [infection](/source/infection).{{cite journal |last1=Garber |first1=B |last2=Glauser |first2=J |title=Viral Meningitis and Encephalitis Update |journal=Current Emergency and Hospital Medicine Reports |date=1 September 2024 |volume=12 |issue=3 |pages=95–102 |doi=10.1007/s40138-024-00294-7 |language=en |issn=2167-4884|doi-access=free }}{{cite journal |last1=Gundamraj |first1=V |last2=Hasbun |first2=R |title=Viral meningitis and encephalitis: an update. |journal=Current Opinion in Infectious Diseases |date=1 June 2023 |volume=36 |issue=3 |pages=177–185 |doi=10.1097/QCO.0000000000000922 |pmid=37093042}} ====Migraine==== [Migraine](/source/Migraine) is a complex neurovascular pain disorder involving blood vessels, neurons, and cerebrospinal fluid within the meninges. The trigeminal nerve, located within the dura mater, carries sensory information about pain, touch, heat and cold from the face to the brain. The hypothalamus receives input from the trigeminal nerve and can modulate trigeminal nerve activity. Migraine patients appear to experience impairments in [cortical habituation](/source/Neural_adaptation), a process which would normally decrease cortical responses to repetitive sensory stimuli.{{cite book |url= |title=Handbook of Clinical Neurology, Vol. 199 (3rd series) Migraine Management |date=1 January 2024 |publisher=Elsevier |isbn=978-0-12-823357-3 |editor-last1=Swanson |editor-first1=JW |editor-last2=Matharu |editor-first2=M |pages=179–200 |chapter=Neuromodulation in migraine |author-first1= KN |author-last1=Arca |author-first2=G |author-last2=Lambru |author-first3= AJ |author-last3= Starling}}{{cite journal |last1=Ning |first1=J |last2=Zhang |first2=Y |last3=Wang |first3=Y |last4=Liu |first4=C |last5=Cheng |first5=Y |last6=Zhu |first6=M |last7=Dong |first7=M |last8=Yang |first8=X |last9=Lv |first9=Y |date=2023 |title=Exploring the cortical habituation in migraine patients based on contingent negative variation. |journal=Frontiers in Neurology |volume=14 |article-number=1226554 |doi=10.3389/fneur.2023.1226554 |doi-access=free |pmid=37719755 |pmc=10502328 }} Initiation of a migraine attack may begin with disruption in the hypothalamus and limbic system. Gradually increasing hypothalamic activity has been observed in the period leading up to a migraine attack, followed by a disruption or collapse of hypothalamic connectivity to the limbic system during an attack.{{cite journal |last1=Stankewitz |first1=A |last2=Keidel |first2=L |last3=Rehm |first3=M |last4=Irving |first4=S |last5=Kaczmarz |first5=S |last6=Preibisch |first6=C |last7=Witkovsky |first7=V |last8=Zimmer |first8=C |last9=Schulz |first9=E |last10=Toelle |first10=TR |title=Migraine attacks as a result of hypothalamic loss of control. |journal=NeuroImage. Clinical |date=2021 |volume=32 |article-number=102784 |doi=10.1016/j.nicl.2021.102784 |pmid=34425551 |pmc=8379646 }} Disruption of the connection between the hypothalamus and limbic system may increase activity in the pain pathway from the trigeminal nerve to the brain, resulting in a migraine attack.{{cite journal |last1=Terrier |first1=LM |last2=Hadjikhani |first2=N |last3=Velut |first3=S |last4=Magnain |first4=C |last5=Amelot |first5=A |last6=Bernard |first6=F |last7=Zöllei |first7=L |last8=Destrieux |first8=C |title=The trigeminal system: The meningovascular complex- A review. |journal=Journal of Anatomy |date=July 2021 |volume=239 |issue=1 |pages=1–11 |doi=10.1111/joa.13413 |pmid=33604906 |pmc=8197948 }} The meninges, particularly the dura mater, are rich in pain-sensitive nerve endings. Sensory information travels along trigeminal nerve fibers to cell bodies located within the trigeminal ganglion (TG). Axons of the trigeminal ganglion neurons enter the brainstem and travel to the trigeminal nucleus caudalis (TNC).{{cite book |last1=Price |first1=S |last2=Daly |first2=DT |title=Neuroanatomy, Trigeminal Nucleus |date=2025|pmid= 30969645 |publisher=StatPearls Publishing |url=https://www.ncbi.nlm.nih.gov/books/NBK539823/ }}{{cite journal |last1=Edvinsson |first1=JCA |last2=Viganò |first2=A |last3=Alekseeva |first3=A |last4=Alieva |first4=E |last5=Arruda |first5=R |last6=De Luca |first6=C |last7=D'Ettore |first7=N |last8=Frattale |first8=I |last9=Kurnukhina |first9=M |last10=Macerola |first10=N |last11=Malenkova |first11=E |last12=Maiorova |first12=M |last13=Novikova |first13=A |last14=Řehulka |first14=P |last15=Rapaccini |first15=V |last16=Roshchina |first16=O |last17=Vanderschueren |first17=G |last18=Zvaune |first18=L |last19=Andreou |first19=AP |last20=Haanes |first20=KA |last21=European Headache Federation School of Advanced Studies |first21=(EHF-SAS) |title=The fifth cranial nerve in headaches. |journal=The Journal of Headache and Pain |date=5 June 2020 |volume=21 |issue=1 |pages=65 |doi=10.1186/s10194-020-01134-1 |doi-access=free |pmid=32503421 |pmc=7275328 }} The activity of [calcitonin gene-related peptide](/source/Calcitonin_gene-related_peptide_receptor_antagonist) (CGRP) in the meninges is linked to migraine.{{cite journal |last1=Levy |first1=D |last2=Moskowitz |first2=MA |title=Meningeal Mechanisms and the Migraine Connection|journal=Annual Review of Neuroscience |date=10 July 2023 |volume=46 |pages=39–58 |doi=10.1146/annurev-neuro-080422-105509 |pmid=36913712 |pmc=11412714 |issn=0147-006X}} CGRP is released from both the trigeminal ganglion (TG) and the trigeminal nucleus caudalis (TNC) in response to trigeminal nerve activation. CGRP activates receptors on meningeal blood vessels, causing dilation and changes in blood flow. CGRP also activates specialized nerve endings on the dura mater (nociceptors) that transmit pain signals from the dura to the central nervous system. Increased neuronal activity in the trigeminal pain pathway reaches higher cortical pain regions via the brainstem, midbrain and thalamus.{{cite journal |last1=Biscetti |first1=L |last2=Cresta |first2=E |last3=Cupini |first3=LM |last4=Calabresi |first4=P |last5=Sarchielli |first5=P |title=The putative role of neuroinflammation in the complex pathophysiology of migraine: From bench to bedside |journal=Neurobiology of Disease |date=1 May 2023 |volume=180 |article-number=106072 |doi=10.1016/j.nbd.2023.106072 |pmid=36907522 |url=https://www.sciencedirect.com/science/article/pii/S0969996123000864 |issn=0969-9961|doi-access=free }} Stimulation of the trigeminal nerve may result in release of [neuropeptides](/source/neuropeptides) such as CGRP, [vasodilation](/source/vasodilation) of cerebral and dural blood vessels, [neurogenic inflammation](/source/neurogenic_inflammation), and the transmission of [pain signals](/source/Nociception) via nerves in the meninges. Cerebrospinal fluid may also play a role in migraine by transferring signals released from the brain to overlying pain-sensitive meningeal tissues, including dura mater. ==Other animals== In [fish](/source/fish), there is a single membrane known as the primitive meninx.{{cite book |last1=Ostrander |first1=Gary |title=The Laboratory Fish |url=https://books.google.com/books?id=Hp4YSFiSD0IC&q=fish+meninges&pg=PT135 |publisher=Elsevier |language=en |date=12 September 2000|isbn=978-0-12-529650-2 }} [Amphibian](/source/Amphibian)s and [reptile](/source/reptile)s have two meninges, and [bird](/source/bird)s and mammals have three. [Mammal](/source/Mammal)s (as higher vertebrates) retain the dura mater, and the secondary meninx divides into the [arachnoid](/source/arachnoid_mater) and [pia mater](/source/pia_mater).{{cite book |last=Kardong |first=Kenneth V. |year=1995 |title=Vertebrates: Comparative Anatomy, Function, Evolution |location=Dubuque, Iowa |publisher=Wm. C. Brown Publishers. |page=539 |isbn=0-697-21991-7}} ==History== The first known reference to the dura appears in Egypt, in Case 6 of the [Edwin Smith Papyrus](/source/Edwin_Smith_Papyrus). [Hippocrates](/source/Hippocrates) described the dura in his monograph "On Injuries of the Head" and insisted that care should be taken to keep it intact and clean.{{cite book |last1=Ganz |first1=JC |chapter=The meninges |title=Cranial Surgery - Part 2 |series=Progress in Brain Research |date=2024 |volume=285 |pages=137–147 |doi=10.1016/bs.pbr.2024.02.020 |pmid=38705713 |isbn=978-0-443-31718-7 }} [Celsus](/source/Celsus) agreed, and described a method of treatment for depressed fractures.{{cite journal |last1=Talamonti |first1=G |last2=D'Aliberti |first2=G |last3=Cenzato |first3=M |title=Aulus Cornelius Celsus and the Head Injuries. |journal=World Neurosurgery |date=January 2020 |volume=133 |pages=127–134 |doi=10.1016/j.wneu.2019.09.119 |pmid=31568909}} [Galen](/source/Galen) was the first to describe the pia mater in humans in the second century AD. [[File:Acta Eruditorum - IV fisiologia, 1703 – BEIC 13363829.jpg|thumb|right|300px|Illustration by [Antonio Pacchioni](/source/Antonio_Pacchioni), ''[Acta Eruditorum](/source/Acta_Eruditorum)'', 1703]] The arachnoid layer was first described by Dutch physician [Gerardus Blasius](/source/Gerard_Blasius) in 1664.{{cite journal |last1=Lu |first1=S |last2=Brusic |first2=A |last3=Gaillard |first3=F |title=Arachnoid Membranes: Crawling Back into Radiologic Consciousness. |journal=AJNR. American Journal of Neuroradiology |date=February 2022 |volume=43 |issue=2 |pages=167–175 |doi=10.3174/ajnr.A7309 |pmid=34711549|pmc=8985673 }} In 1695, [Humphrey Ridley](/source/Humphrey_Ridley) first described the subarachnoid cisterns. He also contributed to the understanding of the blood-brain barrier, and accurately described the fifth cranial nerve ganglion with its branches.{{cite journal |last1=Thakur |first1=JD |last2=Sonig |first2=A |last3=Chittiboina |first3=P |last4=Khan |first4=IS |last5=Wadhwa |first5=R |last6=Nanda |first6=A |title=Humphrey Ridley (1653-1708): 17th century evolution in neuroanatomy and selective cerebrovascular injections for cadaver dissection. |journal=Neurosurgical Focus |date=August 2012 |volume=33 |issue=2 |pages=E3 |doi=10.3171/2012.6.FOCUS12139 |pmid=22853834}} In 1699, [Frederick Ruysch](/source/Frederik_Ruysch) confirmed that the arachnoid mater formed a complete layer that surrounded the brain. Its current name is based on his description of its spiderlike morphology.{{Cite journal |last1=Mortazavi |first1=Martin M. |last2=Quadri |first2=Syed A. |last3=Khan |first3=Muhammad A. |last4=Gustin |first4=Aaron |last5=Suriya |first5=Sajid S. |last6=Hassanzadeh |first6=Tania |last7=Fahimdanesh |first7=Kian M. |last8=Adl |first8=Farzad H. |last9=Fard |first9=Salman A. |last10=Taqi |first10=M. Asif |last11=Armstrong |first11=Ian |last12=Martin |first12=Bryn A. |last13=Tubbs |first13=R. Shane |date=2018-03-01 |title=Subarachnoid Trabeculae: A Comprehensive Review of Their Embryology, Histology, Morphology, and Surgical Significance |url=https://www.sciencedirect.com/science/article/pii/S1878875017321575 |journal=World Neurosurgery |volume=111 |pages=279–290 |doi=10.1016/j.wneu.2017.12.041 |pmid=29269062 |issn=1878-8750|url-access=subscription }} Arachnoid granulations were first described by Italian physician [Antonio Pacchioni](/source/Antonio_Pacchioni) who published his ''Dissertatio Epistolaris de Glandulis Conglobatis Durae Meningis Humanae'' in 1705.{{cite journal |last1=Artico |first1=M |last2=Galassi |first2=FM |last3=Carubbi |first3=C |last4=Vitale |first4=M |last5=Cofone |first5=L |title=Antonio Pacchioni: italian physician and anatomist |journal=The Lancet Neurology |date=1 July 2025 |volume=24 |issue=7 |page=567 |doi=10.1016/S1474-4422(25)00200-5 |pmid=40541203 |url=https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00200-5/abstract?rss=yes |language=English |issn=1474-4422|url-access=subscription }} In seven articles from 1899 to 1902, Italian anatomist [Giuseppe Sterzi](/source/Giuseppe_Sterzi) described comparative studies on the meninges from the [lancelet](/source/lancelet) to the human. He showed that the spinal meninges were very simple in adult lower vertebrates and in the early development of more advanced vertebrates.{{cite journal |last1=Riva |first1=Alessandro |last2=Orrù |first2=Beniamino |last3=Riva |first3=Francesca Testa |title=Giuseppe Sterzi (1876–1919) of the University of Cagliari: A brilliant neuroanatomist and medical historian |journal=The Anatomical Record |date=2000 |volume=261 |issue=3 |pages=105–110 |doi=10.1002/1097-0185(20000615)261:3<105::AID-AR5>3.0.CO;2-H |pmid=10867628 |url=https://anatomypubs.onlinelibrary.wiley.com/doi/full/10.1002/1097-0185%2820000615%29261%3A3%3C105%3A%3AAID-AR5%3E3.0.CO%3B2-H |language=en |issn=1097-0185}} ==See also== * [Cranial cavity](/source/Cranial_cavity) ==Notes== {{Notelist}} ==References== {{Reflist|2}} == External links == * {{Commons category-inline |Meninges}} {{Nervous system}} {{Meninges}} {{Spinal cord}} {{Authority control}} Category:Meninges Category:Back anatomy Category:Human head and neck --- Adapted from the Wikipedia article [Meninges](https://en.wikipedia.org/wiki/Meninges) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Meninges?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.