Blood supply to dura

The meningeal veins accompany the meningeal arteries.

Anterior cranial fossa: Middle cranial fossa: Posterior cranial fossa:
  • Ethmoidal
  • Lacrimal branches of the ophthalmic artery.
  • Middle meningeal
  • Accessory meningeal branches of maxillary artery from the external carotid.
  • Branches of:
  • Vertebral
  • Occipital
  • Ascending pharyngeal.

Innervation of the dura

  • Mainly from branches of the Trigerminal e.g ethmoidal, lacrimal and nervous spinosum .
  • It also gets sensory twigs from Vagus
  • Cervical nerves C1-C2, Facial and Glossopharyngeal.

Note: Sensory endings are more numerous at:

  • Each side of the superior sagittal sinus and tentorium cerebelli.
  • Where arteries and veins pierce the dura mater.
Clinical note:
  • The brain is insensitive to pain, but the cerebral dura is very sensitive, especially around the venous sinuses.
  • Many headaches are of dural and/or vascular origin
  • Indeed, one of the commonest presentations of meningitis is severe headache and neck stiffness.
  • Irritation of C1-C2 in meningitis causes posterior neck muscles to contract causing the stiffness.