Microsurgical Anatomy of the Arachnoidal Trabecular Membranes and Cisterns at the Level of the Tentorium

A clear and thorough understanding of the neuroanatomical structures of the subarachnoid cisterns is important because they provide natural pathways to intracranial arteries, veins, and nerves during microvascular procedures without disturbing surrounding important brain structures. Using a surgical microscope, we examined the microsurgical anatomy of the trabecular membranes and subarachnoid cisterns in 20 adult cadaver brains. The brains were immersed in Ringer's solution and air was injected into the subarachnoid cisterns while the brains remained submerged in solution. We identified seven trabecular membranes that limit six cisterns. We specifically looked at the anatomical relationship between the trabecular membranes and cisterns and their corresponding vessels and cranial nerves. The cistern divisions and the dispositions of trabecular membranes were closely related to the vascular division patterns of the principal brain arteries.