Download Anatomy of the Cerebral Ventricles

ANATOMY OF THE
CEREBRAL VENTRICLES
Francois du Toit
Diagnostic Radiology
Kimberley Hospital
The Cerebral Ventricles

Fluid filled (CSF) spaces within the brain

2 Lateral ventricles in each hemisphere

3rd ventricle, Cerebral Aquaduct, 4th ventricle midline

Ependyma (thin epithelial membrane lining)
The Cerebral Ventricles
THE LATERAL VENTRICLE
The Lateral Ventricles
•
Lies within each cerebral hemisphere:
• Frontal Horn (anterior)
• Body (atrium)
• Temporal Horn (inferior)
• Occipital Horn (posterior)
•
Interventricular Foramen (of Monroe)
• connects each lateral ventricle with the 3rd ventricle
• at junction of anterior horn & body
The Lateral Ventricles
The Lateral Ventricles
THE LATERAL VENTRICLE
FRONTAL HORN
Frontal (anterior) Horn

Extends into frontal lobe

Roof & Ant extremity formed by:


Corpus Collosum (Rostrum & Genu)

Tapetum
Floor & Lateral Wall


Caudate Nucleus
Medial Wall

Septum Pellucidum
Roof / Anterior Border
Roof / Anterior Border
Frontal (anterior) Horn

Extends into frontal lobe

Roof & Ant extremity formed by:


Corpus Collosum (Rostrum & Genu)

Tapetum
Floor & Lateral Wall


Caudate Nucleus
Medial Wall

Septum Pellucidum
Floor of Anterior Horn
Floor of Anterior Horn
Frontal (anterior) Horn

Extends into frontal lobe

Roof & Ant extremity formed by:


Corpus Collosum (Rostrum & Genu)

Tapetum
Floor & Lateral Wall


Caudate Nucleus
Medial Wall

Septum Pellucidum
Medial Wall of Anterior Horn
THE LATERAL VENTRICLE
BODY (atrium)
Body of Lateral Ventricle


In Parietal Lobe
Roof & Lateral Wall



Medial wall




Thalamus
Floor (lateral)


Septum Pellucidum
Floor (medial)


Corpus Callosum
Tapetal Fibres
Body of Caudate Nucleus
Thalamostriate vein in between
Body of Fornix lies above the thalamus
Between the fornix and the thalamus

Choroid plexus lies invaginated into the cavity of the ventricle
in a groove - the choroidal fissure
Roof / Anterior Border
Body of Lateral Ventricle


In Parietal Lobe
Roof & Lat



Medial wall




Thalamus
Floor (lateral)


Septum Pellucidum
Floor (medial)


Corpus Callosum
Tapetal Fibres
Body of Caudate Nucleus
Thalamostriate vein in between
Body of Fornix lies above the thalamus
Between the fornix and the thalamus

Choroid plexus lies invaginated into the cavity of the ventricle
in a groove - the choroidal fissure
Body of Lateral Ventricle


In Parietal Lobe
Roof & Lat



Medial wall




Thalamus
Floor (lateral)


Septum Pellucidum
Floor (medial)


Corpus Callosum
Tapetal Fibres
Body of Caudate Nucleus
Thalamostriate vein in between
Body of Fornix lies above the thalamus
Between the fornix and the thalamus

Choroid plexus lies invaginated into the cavity of the ventricle
in a groove - the choroidal fissure
Body of Lateral Ventricle
Caudate
Nucleus
Thalamus
The Lateral Ventricles
Body of Lateral Ventricle


In Parietal Lobe
Roof & Lat



Medial wall




Thalamus
Floor (lateral)


Septum Pellucidum
Floor (medial)


Corpus Callosum
Tapetal Fibres
Body of Caudate Nucleus
Thalamostriate vein in between
Body of Fornix lies above the thalamus
Between the fornix and the thalamus

Choroid plexus lies invaginated into the cavity of the ventricle
in a groove - the choroidal fissure
The Lateral Ventricles
Body of Fornix
Choroid Plexus
Thalamus
THE LATERAL VENTRICLE
TEMPORAL HORN (inferior)
Temporal (inferior) Horn

Extends anteriorly into Temporal Lobe

Lateral wall


Roof


Fibres of Tapetum
Tail of Caudate Nucleus
Floor

Hippocampus

pes hippocampi anterior

crus of the fornix arising from this
Tapetum
Temporal Horn of
Lateral Ventricle
Temporal (inferior) Horn

Extends anteriorly into Temporal Lobe

Lateral wall


Roof


Fibres of Tapetum
Tail of Caudate Nucleus
Floor

Hippocampus

pes hippocampi anterior

crus of the fornix arising from this
Temporal (inferior) Horn

Extends anteriorly into Temporal Lobe

Lateral wall


Roof


Fibres of Tapetum
Tail of Caudate Nucleus
Floor

Hippocampus

pes hippocampi anterior

crus of the fornix arising from this
Crus of Fornix
Hippocampus
Pes
THE LATERAL VENTRICLE
OCCIPITAL HORN (Posterior)
Occipital (posterior) Horn

Posterior Extension of Lateral ventricle

Extends into Occipital Lobe

Arises from trigone of lateral ventricle

posterior convexity of the body of the lateral ventricle

May be absent / poorly developed / extend the full depth

12% bilaterally well developed
THE CHOROID PLEXUS
Choroid Plexus of Lateral Ventricle

Responsible for most of the production of CSF

Extends from Inferior horn, through body, to interventricular
foramen

NO CHOROID PLEXUS in Occipital & Frontal Horn

Continuous with Choroid Plexus of 3rd ventricle

Invaginated into Lateral Ventricles medially
(Choroidal Fissure)
Choroid Plexus of Lateral Ventricle
Choroid Plexus of Lateral Ventricle

Blood supply:
 Ant Choroidal a. (Branch of ICA)
 Post Choroidal a. (Branch of post Cerebral a.)

Venous drainage:
 Sup Choroidal vein (begins at inferior horn and
passes anteriorly to IV foramen)
 Joins Sup Thalamostriate v. to form Internal Cerebral
vein at IV foramen
rd
3
Ventricle

Slit-like space between Thalami

Width = 2-10mm (increasing with age)

Thin anterior wall – Lamina Terminalis
between ant commissure (above) to optic chiasm
(below)

Extension inferiorly into optic chiasm = supraoptic
recess

Floor = Structures of hypothalamus including pituitary
whose hollow stalk is the infundibular recess of the
ventricle

Fold of Pia containing CP = Tela Choroidea


Narrow Anterior Apex at IV Foramen

Wider Posterior
If Fluid accumulates = Cavum Velum Interpositum
Thalamus
Third Ventricle
rd
3
Ventricle

Slit-like space between Thalami

Width = 2-10mm (increasing with age)

Thin anterior wall – Lamina Terminalis
between ant commissure (above) to optic chiasm
(below)

Extension inferiorly into optic chiasm = supraoptic
recess

Floor = Structures of hypothalamus including pituitary
whose hollow stalk is the infundibular recess of the
ventricle

Fold of Pia containing CP = Tela Choroidea


Narrow Anterior Apex at IV Foramen

Wider Posterior
If Fluid accumulates = Cavum Velum Interpositum
Anterior Commisure
Lamina Terminalis
Optic Chiasm
rd
3
Ventricle

Slit-like space between Thalami

Width = 2-10mm (increasing with age)

Thin anterior wall – Lamina Terminalis
between ant commissure (above) to optic chiasm
(below)

Extension inferiorly into optic chiasm = supraoptic
recess

Floor = Structures of hypothalamus including pituitary
whose hollow stalk is the infundibular recess of the
ventricle

Fold of Pia containing CP = Tela Choroidea


Narrow Anterior Apex at IV Foramen

Wider Posterior
If Fluid accumulates = Cavum Velum Interpositum
rd
3
Ventricle

Slit-like space between Thalami

Width = 2-10mm (increasing with age)

Thin anterior wall – Lamina Terminalis
between ant commissure (above) to optic chiasm
(below)

Extension inferiorly into optic chiasm = supraoptic
recess

Floor = Structures of hypothalamus including pituitary
whose hollow stalk is the infundibular recess of the
ventricle

Fold of Pia containing CP = Tela Choroidea


Narrow Anterior Apex at IV Foramen

Wider Posterior
If Fluid accumulates = Cavum Velum Interpositum
rd
3
Ventricle

Slit-like space between Thalami

Width = 2-10mm (increasing with age)

Thin anterior wall – Lamina Terminalis
between ant commissure (above) to optic chiasm
(below)

Extension inferiorly into optic chiasm = supraoptic
recess

Floor = Structures of hypothalamus including pituitary
whose hollow stalk is the infundibular recess of the
ventricle

Fold of Pia containing CP = Tela Choroidea


Narrow Anterior Apex at IV Foramen

Wider Posterior
If Fluid accumulates = Cavum Velum Interpositum
Cavum Velum Interpositum
rd
3
Ventricle

Posteriorly - extends as small pineal recess into pineal stalk,
and above this into suprapineal recess

Roof - anteriorly, the anterior commissure, column of fornix
and IV foramen.
Behind this the body of the fornix, with Choroid plexus
invaginating below the fornix

60% of people - thalami connected across the ventricle via
massa intermedia (non-neural connection)
rd
3
Ventricle

Posteriorly - extends as small pineal recess into pineal stalk,
and above this into suprapineal recess

Roof - anteriorly, the anterior commissure, column of fornix
and IV foramen.
Behind this the body of the fornix, with Choroid plexus
invaginating below the fornix

60% of people - thalami connected across the ventricle via
massa intermedia (non-neural connection)
Fornix
Choroid Plexus
Ant Commisure
rd
3
Ventricle

Posteriorly - extends as small pineal recess into pineal stalk,
and above this into suprapineal recess

Roof - anteriorly, the anterior commissure, column of fornix
and IV foramen.
Behind this the body of the fornix, with Choroid plexus
invaginating below the fornix

60% of people - thalami connected across the ventricle via
massa intermedia (non-neural connection)
THE CEREBRAL AQUEDUCT
Cerebral Aquaduct

Narrow channel connecting post end of 3rd ventricle
with sup end of 4th ventricle

1.5cm in length. 1-2mm in diameter

Passes through Brainstem with Tectum posterior to it
and Tegmentum and Cerebral Peduncles anteriorly

Nuclei of CN III,IV,V surround aqueduct and are
called the periaqueductal grey matter
Cerebral Aqueduct
th
4
Ventricle

Aqueduct widens Posterior to the Pons

Narrows again in inferior part of medulla as
central canal of the medulla & of spinal cord

Floor = diamond shaped (rhomboid fossa)
Formed by post surface of pons and upper part of medulla

Roof

SUPERIOR
superior cerebellar peduncle with sup medullary velum between
INFERIOR
inf cerebellar peduncle and the inf medullary velum
Over these lies the cerebellum
th
4
Ventricle
th
4
Ventricle
th
4
Ventricle

Aqueduct widens Posterior to the Pons

Narrows again in inferior part of medulla as
central canal of the medulla & of spinal cord

Floor = diamond shaped (rhomboid fossa)
Formed by post surface of pons and upper part of medulla

Roof

SUPERIOR
superior cerebellar peduncle with sup medullary velum between
INFERIOR
inf cerebellar peduncle and the inf medullary velum
Over these lies the cerebellum
th
4
Ventricle Roof
th
4
Ventricle
Foramina
Foramina of
th
4
Ventricle

3 Openings in lower part of roof
 one median aperture (of Magendie)
 large opening in inf medullary velum beneath the
cerebellum, which communicates with the cisterna
magna
 two lateral apertures (of Luschka)
 at apex of lateral recesses of the ventricle
 open anteriorly just behind CN VIII into the pontine
cistern

Choroid plexus invaginates the lower part of its roof and is
supplied by inferior cerebellar a.
Foramen of Magendie
4th Ventricle Foramina

3 Openings in lower part of roof
 one median aperture (of Magendie)
 large opening in inf medullary velum beneath the
cerebellum, which communicates with the cisterna
magna
 two lateral apertures (of Luschka)
 at apex of lateral recesses of the ventricle
 open anteriorly just behind CN VIII into the pontine
cistern

Choroid plexus invaginates the lower part of its roof and is
supplied by inferior cerebellar a.
Foramen of Luschka
4th Ventricle Foramina

3 Openings in lower part of roof
 one median aperture (of Magendie)
 large opening in inf medullary velum beneath the
cerebellum, which communicates with the cisterna
magna
 two lateral apertures (of Luschka)
 at apex of lateral recesses of the ventricle
 open anteriorly just behind CN VIII into the pontine
cistern

Choroid plexus invaginates the lower part of its roof and is
supplied by inferior cerebellar a.
Choroid Plexus of
th
4
Ventricle
CSF PRODUCTION & FLOW
CSF Production & Flow

Total Volume of CSF = 150ml
(25ml is within and around the spinal cord)

Produced at 0.4ml/min

Production independent of CSF pressure

Principally produced by Choroid Plexus of lateral ventricles
CSF Flow

Flows through Interventricular foramen into 3rd ventricle

Via Cerebral Aqueduct to 4th Ventricle

Via Midline Aperture (of Magendie) into Cisterna Magna

Via Lateral Apertures into Pontine Cistern

From Basal Cisterns


some fluid flows down and bathes the spinal cord
The Remainder

passes upward through tentorial hiatus and diffuses over surface of
the cerebral hemispheres
CSF Flow
Into
rd
3
Ventricle (Monroe)
Into
th
4
Venticle (Cerebral Aqueduct)
Into Cisterna Magna (Magendie)
Down to Spinal Cord
Upwards over Cerebral Hemispheres
CSF Absorbtion

CSF is absorbed through the Arachnoid Villi
 herniations of arachnoid through holes in the dura into
venous sinuses
 most numerous in sup sagittal sinus
 discrete in children
 with age they aggregate into visible clumps called
arachnoid granulations
 these indent the inner table of the skull beside the dural
venous sinuses
Arachnoid Villi
CSF Absorbtion

1/3 CSF absorbed along similar spinal villi
OR
escapes along nerve sheaths into perineural lymphatics

This absorption is passive and dependent on hydrostatic
pressure differences
ANATOMICAL VARIANTS
Cavum Velum Interpositum

Fluid Collects in Tela Choroidea
 Narrow
apex anterior
 Wider Posteriorly
Cavum Velum Interpositum
Cavum Septum Pellucidum

Two potential spaces between leaflets of Septum Pellucidum


ANTERIOR Cavum Septum Pellucidum
POSTERIOR Cavum Vergae

Obliterate Postero-anteriorly during development

CSP present in 100% of fetusses

85% Obliterate by 3-6months

Absent CSP in fetus associated with significant CNS
abnormalities
Cavum Vergae



Seperation of the leaflets of septum pellucidum
Posterior extension to the splenium of corpus
collosum
Because of ordered obliteration – CSP almost always
accompanies a Cavum Vergae
Cavum Vergae
Cavum
Septum
Pellucidu
m
Cavum
Vergae
References

Anatomy for Diagnostic Imaging,
rd
3
Stephanie Ryan, Michelle McNicholas, Stephen Eustace

Atlas of Human Anatomy, 2nd Edition
Frank H. Netter

http://www.imaios.com/

http://www.radiopaedia.org/
Edition