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Subarachnoid cisterns are enlarged spaces within the subarachnoid space, where cerebrospinal fluid (CSF) accumulates between the pia mater and arachnoid mater. They form due to widening of the subarachnoid space around important neurovascular structures.
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They are critical landmarks in neuroanatomy, radiology, and neurosurgery, as many arteries, veins, and cranial nerves traverse them.
https://doi.org/10.7759/cureus.23741
Classification of the subarachnoid cisterns
Rai S, Srivastava S, Kamath M, Murlimanju BV, Parmar G, Chebrolu G. Delineation of Subarachnoid Cisterns Using CT Cisternography, CT Brain Positive and Negative Contrast, and a Three Dimensional MRI Sequence: A Pictorial Review. Cureus. 2022;14(4):e23741. Published 2022 Apr 1. doi:10.7759/cureus.23741
Major Subarachnoid Cisterns
| Cistern | Location | Contents | Clinical |
|---|---|---|---|
| Cisterna Magna (Cerebellomedullary Cistern) | Between inferior surface of cerebellum and dorsal medulla | Vertebral arteries, PICA, cranial nerves IX, X, XI roots | Common site for CSF sampling (cisternal puncture) |
| Pontine Cistern (Prepontine Cistern) | Ventral to the pons, between pons and clivus | Basilar artery and branches, CN VI | Aneurysms of basilar tip, clival chordomas, and brainstem compression seen here |
| Interpeduncular Cistern | Between cerebral peduncles, beneath floor of third ventricle | Circle of Willis components (basilar tip, PCA, PCoA, SCA), CN III | Frequent site for aneurysms (basilar tip, PCoA aneurysms) |
| Chiasmatic (Suprasellar) Cistern | Above sella turcica, around optic chiasm | Optic chiasm/tracts, ACA and AComA, pituitary stalk | Pituitary tumors, craniopharyngiomas, and aneurysms of ACA/AComA region |
| Ambient Cistern | Lateral midbrain, connecting interpeduncular cistern with quadrigeminal cistern | PCA, SCA, CN IV | Important corridor in neurosurgery; compressed in tentorial herniation |
| Quadrigeminal Cistern (Superior Cistern) | Posterior to midbrain tectum (colliculi). | Great vein of Galen, pineal gland, posterior cerebral and superior cerebellar arteries. | Site for vein of Galen malformations, pineal tumors |
| Cisterna Lata (Sylvian Fissure Cistern) | Along lateral (Sylvian) fissure. | Middle cerebral artery (MCA) and branches. | Site of MCA aneurysms, subarachnoid hemorrhage accumulation |
Schematic representation of the subarachnoid cisterns in the midsagittal plane
Rai S, Srivastava S, Kamath M, Murlimanju BV, Parmar G, Chebrolu G. Delineation of Subarachnoid Cisterns Using CT Cisternography, CT Brain Positive and Negative Contrast, and a Three Dimensional MRI Sequence: A Pictorial Review. Cureus. 2022;14(4):e23741. Published 2022 Apr 1. doi:10.7759/cureus.23741
Schematic representation of the subarachnoid cisterns as seen from an inferior view.
BA: Basilar Artery; SCA: Superior Cerebellar Artery; PCA: Posterior Cerebral Artery; PCoA: Posterior Communicating Artery; MCA: Middle Cerebral Artery; ACA: Anterior Cerebral Artery; CN: Cranial Nerve.
Rai S, Srivastava S, Kamath M, Murlimanju BV, Parmar G, Chebrolu G. Delineation of Subarachnoid Cisterns Using CT Cisternography, CT Brain Positive and Negative Contrast, and a Three Dimensional MRI Sequence: A Pictorial Review. Cureus. 2022;14(4):e23741. Published 2022 Apr 1. doi:10.7759/cureus.23741
Other Important Cisterns
https://doi.org/10.7759/cureus.23741
