From the Guidelines
The basal cisterns are critical cerebrospinal fluid (CSF)-filled spaces at the base of the brain, surrounding the ventral surface of the brain and brainstem, and are particularly relevant in the context of subarachnoid hemorrhage (SAH), as they are involved in 70% of cases of ruptured cerebral aneurysm, as noted in the study by Ledbetter et al 1. The basal cisterns include several major compartments such as the interpeduncular cistern, chiasmatic cistern, ambient cistern, quadrigeminal cistern, and cerebellopontine angle cistern, which are essential for cushioning and protecting the brain. These cisterns function as reservoirs for CSF and contain important blood vessels, including the circle of Willis, and cranial nerves, making them clinically significant in the diagnosis and management of neurological conditions, including SAH, which has a high morbidity and mortality rate, with a quarter of aneurysmal subarachnoid patients dying after presentation, as highlighted in the study by Ledbetter et al 1. Key points about the basal cisterns include:
- They are CSF-filled spaces located at the base of the brain
- They surround the ventral surface of the brain and brainstem
- They are involved in the circulation of CSF throughout the central nervous system
- They contain important blood vessels and cranial nerves
- They are significant in the diagnosis and management of SAH and other neurological conditions, as discussed in the context of the ACR Appropriateness Criteria for cerebrovascular diseases, including aneurysm, vascular malformation, and subarachnoid hemorrhage 1.
From the Research
Definition and Function of Basal Cisterns
- The basal cisterns are expansions of the subarachnoid space that transmit cranial nerves and intracranial vessels 2.
- They play a crucial role in providing a safe passage for neurosurgeons during surgical approaches to intracranial vessels and nerves for the treatment of aneurysms, arteriovenous malformations, and basal tumors 3.
Anatomical Description
- The basal subarachnoid cisterns include their embryology, history, anatomical descriptions, and use during surgical approaches 2.
- The cisterns are part of the cerebrospinal fluid (CSF) space, which consists of the intracerebral ventricles, subarachnoid spaces of the spine and brain, and the central spinal cord canal 4.
Clinical Significance
- The basal cisterns are involved in the circulation of CSF, which protects the central nervous system (CNS) by regulating metabolic homeostasis, supplying nutrients, functioning as a lymphatic system, and regulating intracranial pressure 4.
- Alterations in the CSF dynamics between the basal cisterns and the subarachnoid space of the optic nerve can be observed in patients with papilloedema, suggesting reduced CSF turnover in the subarachnoid space of the optic nerve 5.