Turkish Neurosurgery 2011 , Vol 21 , Num 3
Subarachnoid, Subdural and Interdural Spaces at the Clival Region: An Anatomical Study
Giyas AYBERK1, Mehmet Faik OZVEREN2, Sevil ASLAN1, Mesut Emre YAMAN1, Onur YAMAN3, Selim KAYACI4, Ibrahim TEKDEMIR5
1M.H. Ataturk Training and Research Hospital, 2nd Department of Neurosurgery, Ankara, Turkey
2Rize University, Faculty of Medicine, Department of Neurosurgery, Rize, Turkey
3M.H. Rize Training and Research Hospital, Department of Neurosurgery, Rize, Turkey
4Sar Hospital, Department of Neurosurgery, Rize, Turkey
5Ankara University, Faculty of Medicine, Department of Anatomy, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.3913-10.1 AIM: We aimed to show the significance of the anterior pontine membrane as a determining structure between the subdural and subarachnoid space in the clival region.

MATERIAL and METHODS: Five adult cadaver heads and five cerebral hemispheres were used. The skull vault and hemipheres were removed by sectioning through the pontomesencephalic junction. Five other heads hemispheres were removed but the arachnoid membrane was protected and the cerebral side of the clival dura mater was dissected. In another specimen, the dural porus of the abducens nerve was sectioned for histological evaluation. Three cases of hematoma at the clivus were presented to support our findings.

RESULTS: The anterior pontine membrane is the arachnoid membrane forming the anterior wall of the prepontine cistern with its lateral extension at the skull base. This membrane forms the subdural and subarachnoid spaces by forming a barrier between the clival dura mater and neurovascular structures of the brainstem. There were rigid fibrous trabeculations between both cerebral and periosteal dural layers forming the basilar plexus as the interdural space in the clivus.

CONCLUSION: The anterior pontine membrane separates the subdural and subarachnoid spaces at the clival region. The hematomas of the clival region require to be evaluated with consideration given to the existance of the subdural space. Keywords : Anterior pontine membrane, Arachnoid, Clivus, Interdural space

Corresponding author : Giyas Ayberk, giyas67@hotmail.com