The innervation of the cranial dura mater

Neurosurgical case correlates and a review of the literature

William J. Kemp, R. Shane Tubbs, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: Headache and postcraniotomy pain can be disabling. In addition, generation of pain on manipulation of dural membranes during an awake craniotomy can limit the mapping procedure and create significant discomfort for the patient. There is controversy regarding the distribution of innervation of the cranial dura mater. Our aim was to review the literature regarding the innervation of the cranial dura mater and provide surgical case illustrations to highlight the relevance of such innervation to the neurosurgeon. Methods: A review of the literature regarding the nerves thought to innervate the cranial dura mater was performed. Case illustrations are provided to highlight such innervation patterns. Results: The cases provided reinforce the finding that the posterior part of the falx cerebri, tentorium cerebelli, and the dura mater along the middle cranial fossa floor are heavily innervated and most likely cause intense pain by their manipulation, which should therefore be avoided, if possible, during surgical procedures. Conclusions: Knowledge of the nerves that supply the dura mater of the skull and their pathways is important to the clinician who treats headache and to the neurosurgeon who operates in this region.

Original languageEnglish
Pages (from-to)505-510
Number of pages6
JournalWorld Neurosurgery
Volume78
Issue number5
DOIs
StatePublished - Nov 2012

Fingerprint

Dura Mater
Pain
Headache
Spinal Cord
Middle Cranial Fossa
Craniotomy
Skull
Membranes

Keywords

  • Cranial nerves
  • Craniotomy
  • Dura mater
  • Neurosurgical procedures
  • Pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

The innervation of the cranial dura mater : Neurosurgical case correlates and a review of the literature. / Kemp, William J.; Tubbs, R. Shane; Cohen-Gadol, Aaron.

In: World Neurosurgery, Vol. 78, No. 5, 11.2012, p. 505-510.

Research output: Contribution to journalArticle

@article{e0e25400a1724e3da171054d0f6c3616,
title = "The innervation of the cranial dura mater: Neurosurgical case correlates and a review of the literature",
abstract = "Objective: Headache and postcraniotomy pain can be disabling. In addition, generation of pain on manipulation of dural membranes during an awake craniotomy can limit the mapping procedure and create significant discomfort for the patient. There is controversy regarding the distribution of innervation of the cranial dura mater. Our aim was to review the literature regarding the innervation of the cranial dura mater and provide surgical case illustrations to highlight the relevance of such innervation to the neurosurgeon. Methods: A review of the literature regarding the nerves thought to innervate the cranial dura mater was performed. Case illustrations are provided to highlight such innervation patterns. Results: The cases provided reinforce the finding that the posterior part of the falx cerebri, tentorium cerebelli, and the dura mater along the middle cranial fossa floor are heavily innervated and most likely cause intense pain by their manipulation, which should therefore be avoided, if possible, during surgical procedures. Conclusions: Knowledge of the nerves that supply the dura mater of the skull and their pathways is important to the clinician who treats headache and to the neurosurgeon who operates in this region.",
keywords = "Cranial nerves, Craniotomy, Dura mater, Neurosurgical procedures, Pain",
author = "Kemp, {William J.} and Tubbs, {R. Shane} and Aaron Cohen-Gadol",
year = "2012",
month = "11",
doi = "10.1016/j.wneu.2011.10.045",
language = "English",
volume = "78",
pages = "505--510",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - The innervation of the cranial dura mater

T2 - Neurosurgical case correlates and a review of the literature

AU - Kemp, William J.

AU - Tubbs, R. Shane

AU - Cohen-Gadol, Aaron

PY - 2012/11

Y1 - 2012/11

N2 - Objective: Headache and postcraniotomy pain can be disabling. In addition, generation of pain on manipulation of dural membranes during an awake craniotomy can limit the mapping procedure and create significant discomfort for the patient. There is controversy regarding the distribution of innervation of the cranial dura mater. Our aim was to review the literature regarding the innervation of the cranial dura mater and provide surgical case illustrations to highlight the relevance of such innervation to the neurosurgeon. Methods: A review of the literature regarding the nerves thought to innervate the cranial dura mater was performed. Case illustrations are provided to highlight such innervation patterns. Results: The cases provided reinforce the finding that the posterior part of the falx cerebri, tentorium cerebelli, and the dura mater along the middle cranial fossa floor are heavily innervated and most likely cause intense pain by their manipulation, which should therefore be avoided, if possible, during surgical procedures. Conclusions: Knowledge of the nerves that supply the dura mater of the skull and their pathways is important to the clinician who treats headache and to the neurosurgeon who operates in this region.

AB - Objective: Headache and postcraniotomy pain can be disabling. In addition, generation of pain on manipulation of dural membranes during an awake craniotomy can limit the mapping procedure and create significant discomfort for the patient. There is controversy regarding the distribution of innervation of the cranial dura mater. Our aim was to review the literature regarding the innervation of the cranial dura mater and provide surgical case illustrations to highlight the relevance of such innervation to the neurosurgeon. Methods: A review of the literature regarding the nerves thought to innervate the cranial dura mater was performed. Case illustrations are provided to highlight such innervation patterns. Results: The cases provided reinforce the finding that the posterior part of the falx cerebri, tentorium cerebelli, and the dura mater along the middle cranial fossa floor are heavily innervated and most likely cause intense pain by their manipulation, which should therefore be avoided, if possible, during surgical procedures. Conclusions: Knowledge of the nerves that supply the dura mater of the skull and their pathways is important to the clinician who treats headache and to the neurosurgeon who operates in this region.

KW - Cranial nerves

KW - Craniotomy

KW - Dura mater

KW - Neurosurgical procedures

KW - Pain

UR - http://www.scopus.com/inward/record.url?scp=84868568711&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868568711&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2011.10.045

DO - 10.1016/j.wneu.2011.10.045

M3 - Article

VL - 78

SP - 505

EP - 510

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

IS - 5

ER -